七氟醚预处理对缺血再灌注心肌膜修复蛋白MG53表达的影响

The effect of sevoflurane pretreatment on the expression of myocardial membrane repair protein MG53 during ischemia-reperfusion

目的探讨七氟醚预处理对缺血再灌注心肌膜修复蛋白MG53表达的影响。方法选取80例需要手术纠治的室间隔缺损患儿,随机分为两组(每组40例),其中C组为对照组,S组为七氟醚预处理组。S组于气管插管后给予七氟醚吸入30 min,维持1.0 MAC,随后洗脱10 min,使主动脉阻断前七氟醚吸入浓度为零;C组则单纯行空-氧混合通气,其余两组患儿麻醉方案相同。两组患儿分别于诱导(T0)和主动脉开放3 h(T1)、6 h(T2)经中心静脉抽血测定CK-MB、cTnl的浓度,并在CPB开始前(T3)和心脏再灌注血流动力学指标稳定20 min(T4)后,剪取适量未损伤的右心耳组织,采用蛋白免疫印迹法检测组织中MG53蛋白的表达,同时记录患儿术后临床指标。结果组内比较T1、T2时S组和C组的CK-MB、cTnI较T0时增高(P<0.05);组间比较,S组的CK-MB、cTnI在T1、T2时较C组低(P<0.05),差异有统计学意义;T3时两组MG53蛋白表达量差异无统计学意义,T4时两组患儿MG53蛋白表达量均较T3时低(P<0.05);同时T4时S组MG53表达量高于C组(P<0.05);两组患儿术后临床指标比较差异无统计学意义。结论七氟醚预处理可以增加缺血再灌注心肌细胞膜修复蛋白MG53的表达,从而发挥心肌保护作用。

Objective The aim of this study is to explores the effect of sevoflurane pretreatment on the expression of myocardial membrane repair protein MG53 during ischemia-reperfusion.Methods 80 cases of interventricular septum defect requiring surgical correction were included in this study.The patients were assigned into sevoflurane pretreatment group(S-group)and control group(C-group).S-group received sevoflurane inhalation for 30 minutes after tracheal intubation,maintained at 1.0 MAC,then eluted for 10 minutes,stop administering sevoflurane inhalation before aortic occlusion.C-group was given mixed air oxygen ventilation.The other anesthesia intervention conditions in two groups are consistent.The concentrations of CK-MB and cTnl of the venous blood in the two groups were detected at the time of anesthesia induction(T0),the time of 3 hours after arterial opening(T1),the time of 6 hours after arterial opening(T2).We collected an appropriate amount of right atrial appendage tissue of the heart at the time of beginning of CPB(T3)and at the time of hemodynamic indicators remain stable for 20 minutes after cardiac reperfusion,and used protein immunoblotting to detect the expression of MG53 in tissues.Results Respectively compared with T0,the CK MB/cTnI at T1/T2 in S-group significant increase(P<0.05).The consistent results were also obtained in C-group.Compared with the C-group,the CK MB and cTnI in the S-group decreased at T1 and T2(P<0.05).There was no statistically significant difference in the expression of MG53 between the two groups at T3.The expression of MG53 was lower in both groups at T4 than at the time of T3(P<0.05).At the same time,the expression of MG53 in S-group was higher than that in C-group at T4(P<0.05).Conclusion Preconditioning with sevoflurane can increase the expression of myocardial cell membrane repair protein MG53 during ischemia-reperfusion,which has a myocardial protective effect.