瑞芬太尼聚己内酯对脊髓缺血再灌注损伤兔体感诱发电位的影响

Effect of REM-PCL on somatosensory-evoked potential of rabbits with spinal cord ischemia reperfusion injury

目的:观察腹主动脉内灌注Mu阿片受体(MOR)激动剂瑞芬太尼聚己内酯(REM-PCL)对脊髓缺血再灌注损伤(SCIRI)兔体感诱发电位(SEP)的影响。方法:30只健康新西兰大白兔随机分为对照组、R组和RG组,每组10只。R组和RG组采用肾下腹主动脉阻断法制备SCIRI模型,于阻断血流时经腹主动脉局部灌注REM-PCL 0.1mg/kg,RG组于REM-PCL灌注结束后再局部灌注MOR拮抗剂GSK1521498(1 mg/kg),对照组局部灌注等容量生理盐水。分别于阻断前,再灌注15、30、60 min及再灌注24 h监测血清神经特异性烯醇化酶(NSE)质量浓度和SEP;再灌注6、12和24 h进行神经行为学评分,然后于再灌注24 h取脊髓组织检测MOR mRNA和感觉神经元异常率。结果:3组血清NSE质量浓度变化、SEP变化、神经行为学评分、脊髓组织MOR mRNA表达水平和感觉神经元异常率差异均有统计学意义(P均<0.05)。RG组上述指标测值及变化趋势与对照组相似(P>0.05)。与对照组和RG组比较,再灌注期间R组血清NSE质量浓度明显较低,SEP OL延长程度较小,IPA较快恢复,神经行为学评分较低;再灌注24 h时,R组脊髓组织MOR mRNA表达水平较高,感觉神经元异常率明显较低(P<0.05)。结论:腹主动脉内灌注REM-PCL可以通过激活MOR,减轻脊髓电生理功能障碍。

Aim： To investigate the effect of Mu-opioid receptor（MOR） agonist remifentanil-poly-caprolactone（REM-PCL） on the somatosensory evoked potential（SEP） of rabbits with spinal cord ischemia reperfusion injury（SCIRI）. Meth-ods： A total of 30 healthy rabbits were randomly allocated into control group, R group and RG group, 10 rabbits in each group. In group R and RG, the infrarenal abdominal aorta occlusion method was used to establish SCIRI model, and then REM-PCL was perfused at 0. 1 mg/ kg by abdominal aorta; RG group were given local perfusion of MOR antagonist GSK1521498（1 mg/ kg）, and the rabbits in the control group were perfused with normal saline. Before occlusion, after reperfusion for 15, 30, 60 min and reperfusion for 24 h, the serum neuron specific enolase（NSE） concentration and SEP were monitored; after reperfusion for 6, 12 and 24 h, neurobehavioral score was assessed and MOR mRNA and sensory neurons abnormal rate in spinal cord tissue were detected. Results： The differences in serum NSE level, SEP changes, neurobehavioral score, MOR mRNA expression and sensory neurons abnormal rate among the 3 groups were statistically sig-nificant（P 〈 0. 05）. The indexes mentioned above and the change trend of RG group were similar to those of the control group（P 〉 0. 05）. Compared with the control group and RG group, during reperfusion, OL showed a lesser extent, IPA re-covered rapidly, the concentration of serum NSE and neurobehavioral scores were lower in R group;after reperfusion for 24 h, MOR mRNA expression in spinal cord tissue were higher, and sensory neuron abnormal rate was significantly lower（P 〈0. 05）. Conclusion： REM-PCL perfusion in abdominal aorta could relieve spinal cord electrophysiological dysfunction by activating MOR.