缺血-再灌注期心肌组织及血清白细胞介素-1β和白细胞介素-6的变化

The changes of myocardium and serum interleukin-1β and interleukin-6 in rabbits following myocardial ischemia and reperfusion

目的 观察家兔缺血 再灌注期心肌组织及血清白细胞介素 1β(IL 1β)、白细胞介素 6(IL 6 )的变化和芬太尼对其影响。方法 2 4只家兔随机分为假手术组 (C组 )、缺血 再灌注组 (IR组 )和芬太尼组 (F组 ) ,每组 8只。IR组行冠状动脉左前降支阻断 30分钟 ,再灌注 3小时 ;F组缺血前 2 0分钟缓慢静注芬太尼 5 0 μg/kg后 ,以 40 0 μg·kg-1·h-1速度维持 ;C组仅分离血管 ,不阻断血流。三组分别于缺血前 5分钟 (I0 )、缺血 30分钟 (I1)、再灌注 1小时 (R1)和 3小时 (R2 )取颈内静脉血 ,并于实验结束时取心肌组织 ,测定血清及心肌组织中IL 1β和IL 6浓度 ,光镜下观察心肌病理结构变化。结果 F组血清IL 1β在R1时达到峰值 ,为I0 的 2 98倍 (P <0 0 1) ,在R2 时下降 (P <0 0 5 ) ;IL 6在R2 时升高 ,为I0 的 1 33倍 (P <0 0 5 )。IR组血清IL 1β在I1～R2 时增高 ,分别是I0 的2 90、4 85和 3 88倍 (P <0 0 1) ;血清IL 6在R1和R2 时持续升高 (P <0 0 1) ,分别为I0 的 1 5 6、1 74倍。F组心肌组织中IL 1β及IL 6含量较C组增高 ,但明显低于IR组 (P <0 0 1)。光镜下F组心肌中度水肿 ,白细胞散在浸润 ;IR组水肿严重 ,白细胞浸润明显。结论 缺血 再灌注时心肌组织和血清IL 1β、IL 6的合成增加 。

Objective To observe the changes of myocardium and serum interleukin-1β(IL-1β) and interleukin-6(IL-6) following myocardial ischemia and reperfusion.Methods Twenty-four rabbits were randomly divided into three groups:sham operation group(group C,n=8) was given nothing as a control.Ischemia reperfusion group(group IR,n=8) was subjected to a 30min of left anterior descending coronary artery(LAD) occlusion followed by reperfusion for 3h.Fentanyl group(group F,n=8) was given fentanyl 50μg/kg 20min before the occlusion and followed by 400μg·kg -1·h -1 till the end of the experiment.IL-1β and IL-6 were measured at following points:5min before occlusion(I 0),30min after occlusion(I 1),1h(R 1) and 3h(R 2) after reperfusion.The pathological changes of the myocardium were investigated under light microscope.Results In group F,serum IL-1β increased rapidly at R 1(P<0.01),then decreased at R 2,while serum IL-6 increased at R 2(P<0.05).In group IR,serum IL-1β reached to a peak value at R 1(P<0.01) and decreased a little at R 2(P<0.01),which was still higher than that in group C and F(P<0.01).Serum IL-6 rose obviously at R 1(P<0.01),and was kept at a higher level till the end of the reperfusion.Myocardial IL-1β and IL-6 were higher in group IR than those in group F and group C(P<0.01).Under light microscope,mild myocardium edema and only a few inflammatory cells were found in group F.Such changes were more serious in group IR.Conclusion The levels of IL-1β and IL-6 of serum and myocardium were increased significantly following myocardial ischemia and reperfusion,and fentanyl can attenuate the responses of IL-1β and IL-6 to ischemia-reperfusion injury.