硝酸甘油对CO_2气腹兔眼内压及脉络膜心钠素表达的影响

Effects of Nitroglycerin on Intraocular Pressure and Choroidal Atrial Natriuretic Polypeptide Expression of CO_2 Pneumoperitoneum Rabbits

目的观察硝酸甘油对CO2气腹兔眼内压(IOP)及脉络膜心钠素(ANP)表达的影响。方法选取普通健康家兔24只,采用随机数字表法分为假气腹组(SP组)、气腹组(P组)、气腹加硝酸甘油组(N组)3组,每组8只。麻醉诱导及维持应用丙泊酚,诱导后气管切开控制通气,并经左颈总动脉穿刺监测有创动脉压,P组、N组建立CO2气腹,SP组不加气腹。3组均以微量泵持续输注丙泊酚20~30 mg/(kg·min)维持麻醉,同时N组微量泵持续输注硝酸甘油,从1μg/(kg·min)调整剂量以维持循环稳定。测量并记录麻醉前(T0),气管插管及建立有创动脉压监测后1 h(T1),2 h(T2),3 h(T3)时的平均动脉压(MAP)、心率(HR),IOP。于T3时处死动物,留取眼球脉络膜组织进行免疫组化染色测定脉络膜ANP的表达(以平均灰密度值表示)。结果 P组、N组IOP T1~T3较T0增高(P<0.05);IOP T1~T3P组、N组高于SP组(P<0.05),N组低于P组(P<0.05)。3组各时点MAP、HR比较差异无统计学意义(P>0.05)。P组T1~T3时脉络膜ANP表达较T0增强(P<0.05),N组表达减弱(P<0.05);P组T1~T3时脉络膜ANP表达强于SP组、N组弱于P组(P<0.05)。结论硝酸甘油控制降压可降低CO2气腹兔的IOP、减少脉络膜ANP的分泌,有利于维持CO2气腹过程中血容量及内环境的稳定。

Objective To investigate the effects of Nitroglycerin on intraocular pressure （IOP） and choroidal atrial natriuretic polypeptide （ANF） expression of CO2 pneumoperitoneum rabbits. Methods A total of 24 healthy rabbits were di- vided into sham pneumoperitoneum group （group SP, n = 8）, pneumoperitoneum group （group P, n = 8） and pneumoperitone- um and Nitroglycerin group （group N, n = 8） using random digits table method. Anesthesia was induced and maintained with Propofol. After induction, ventilation was controlled through the tracheotomy, and invasive angiosthenia was monitored by puncturing through left common carotid artery. CO2 pneumoperitoneum was established in groups P and N, but there was no CO2 pneumoperitoneum in group SP. The three groups were continually treated with 20-30 mg/（kg· min） Propofol for keeping anesthesia, and group N was continually injected with Nitroglycerin with micro pump at the same time, and 1μg/（kg ~ min） was the modifying dosage to keep stable circulation. The values of mean arterial pressure （MAP）, heart rate （HR） and IOP were measured and recorded before anesthesia （To ）, and 1 h （ T1 ）, 2 h （T2 ） and 3 h （T3 ） after tracheal intubation and inva- sire angiosthenia monitoring. Rabbits were sacrificed at T3, and the ocular choroid tissues were obtained, and then immuno- histochemisty staining was performed to detect choroidal ANP expression. Results The IOP values in T~ -T3 were significantly higher than those at To in group P and N （P 〈 0. 05） ; the IOP values in T,-T3 in group P and N were significantly higher than those in group SP （P 〈 0. 05）, but the values in group N were significantly lower than those in group P （P 〈 0. 05 ）. There were no significant differences in MAP and HR values among the three groups at each time point （P 〉 0. 05）. Choroidal ANP expressions in T^-T3 in group P were significantly stronger than that at To （P 〈0. 05）, while the expression in group N became weaker （P 〈0. 05）. Choroidal ANP expression in T^-T3 in group P were stronger than those in group SP, but the expressions in group N were weaker than those in group P （P 〈 0. 05）. Conclusion Controlled hypotension with Nitroglycerin can reduce IOP and decrease their secretion of choroidal ANP of CO2 pneumoperitoneum rabbits, and it is conducive to keeping the stabili- ty of blood volume and internal environment during CO2 pneumoperitoneum.