右美托咪定对红细胞变形性影响的体外研究

The Effects of Dexmedetomidine on the Deformability of Erythrocyte in Vitro

目的:研究右美托咪定(DEX)对离体红细胞变形性的影响,探讨其作用机制。方法:采健康志愿者人血5 m L制成2%红细胞悬液,分成空白对照组(C组),低浓度DEX组(DL组)、中浓度DEX组(DM组)、高浓度DEX组(DH组),单纯育亨宾(Y组)以及育亨宾+DEX组(YD组),每组9例。将各组样本放入37℃恒温震荡培养箱中60 min后取出,测定红细胞变形性指数(EI)、红细胞内一氧化氮(NO)含量以及内皮型一氧化氮合酶(e NOS)含量。结果:与C组比较,DL组、DM组、DH组及YD组中EI、红细胞内NO、e NOS的含量增高(P<0.05);Y组含量差异无统计学意义(P>0.05)。与YD组比较,DM组EI、红细胞内NO及e NOS含量增高(P<0.05)。结论:DEX可以提高离体红细胞的变形能力,其可能机制是通过激活红细胞膜上肾上腺素受体,激活红细胞内e NOS使细胞内NO增多有关。

Objective： To evaluate the impact of clinically relevant concentrations of dexmedetomidine on the deformability of erythrocyte in vitro. Methods： 5 m L intravenous blood samples taken from healthy adults were made into erythrocyte suspensions with 2% HCT in PBS buffer. Erythrocyte suspensions were divided into 6 groups： control group（group C）; low concentration of dexmedetomidine group（group DL）; middle concentration of dexmedetomidine（group DM）; high concentration of dexmedetomidine（group DH）; yohimbine alone（group Y） and yohimbine mixed with dexmedetomidine（group YD）, with 9 cases in each group. 6 groups were placed into thermostatic incubator concussion 50 rpm, 37 ℃. After incubation for 60 min, the concentration of NO and e NOS of red blood cell and deformability of erythrocyte were measured respectively. Results： The EI and the activity of e NOS and content of NO of erythrocyte were significantly higher in group DL, DM, DH and YD than in group C（P〈 0.05）. There was no significant difference in the indexes metioned above between group Y and group C（P〉 0.05）. Compared with group YD, the EI and the activity of e NOS and concentration of NO of erythrocyte increased in group DM（P〈 0.05）. Conclusion： Dexmedetomidine treatment can improve deformability of erythrocyte. The improvement effect of dexmedetomidine on erythrocyte deformability is partially associated with adrenergic receptors through excitement of e NOS to enhance the concentration of NO of red blood cell.