Rao Yan, Wang Yan-lin, Zhang Wen-sheng, Liu Jin
Department of Anesthesiology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei, China.
Anesth Analg. 2008 May;106(5):1353-9, table of contents. doi: 10.1213/ane.0b013e3181679347.
In this study, we examined the cardioprotective effects of parental emulsified isoflurane compared with inhaled isoflurane.
Thirty-two rabbits were subjected to 30 min of myocardial ischemia induced by temporary ligation of the left anterior descending coronary artery followed by 3 h of reperfusion. Before left anterior descending coronary artery occlusion, the rabbits were randomly allocated into one of four groups (eight for each group): group C, no ischemia preconditioning treatment; group IS, inhaled isoflurane 1.1% end-tidal; group EI, a continuous infusion of 8% emulsified isoflurane to an end-tidal concentration of 0.64%; and group IN, a continuous infusion of 30% Intralipid started 30 min. Treatments were started 30 min before ischemia followed by a 15 min washout period for isoflurane groups. Myocardial infarct volume, lactate dehydrogenase, and creatine kinase levels were measured and changes in mitochondrial ultrastructure assessed after 3 h myocardial reperfusion.
Myocardial infarct size 3 h after reperfusion was lower in groups IS and EI compared with groups C and IN (20% +/- 8%, 18% +/- 8%, 39% +/- 6%, and 34% +/- 9%, respectively, P < 0.01). There were no differences in myocardial infarct size between groups IS and EI or between groups C and IN. Plasma lactate dehydrogenase and creatine kinase levels were lower in group IS (456 +/- 58 U/L and 1725 +/- 230 U/L) and group EI (451 +/- 54 U/L and 1686 +/- 444 U/L) 3 h after myocardial reperfusion compared with groups C (676 +/- 82 U/L and 2373 +/- 529 U/L; P < 0.01). Mitochondrial ultrastructure changes were less pronounced in groups IS and EI compared with group C.
Our results indicate that, in rabbits, i.v. emulsified isoflurane provides similar myocardial protection against ischemia-reperfusion injury as inhaled isoflurane.
在本研究中,我们比较了静脉注射乳化异氟醚与吸入异氟醚的心脏保护作用。
32只兔子接受左冠状动脉前降支临时结扎诱导的30分钟心肌缺血,随后再灌注3小时。在左冠状动脉前降支闭塞前,将兔子随机分为四组之一(每组8只):C组,无缺血预处理;IS组,呼气末吸入1.1%异氟醚;EI组,持续输注8%乳化异氟醚使呼气末浓度达到0.64%;IN组,在缺血前30分钟开始持续输注30%脂质乳剂。在缺血前30分钟开始治疗,异氟醚组随后有15分钟的洗脱期。在心肌再灌注3小时后测量心肌梗死体积、乳酸脱氢酶和肌酸激酶水平,并评估线粒体超微结构的变化。
再灌注3小时后,IS组和EI组的心肌梗死面积低于C组和IN组(分别为20%±8%、18%±8%、39%±6%和34%±9%,P<0.01)。IS组和EI组之间以及C组和IN组之间的心肌梗死面积无差异。与C组相比,心肌再灌注3小时后,IS组(456±58 U/L和1725±230 U/L)和EI组(451±54 U/L和1686±444 U/L)的血浆乳酸脱氢酶和肌酸激酶水平较低(P<0.01)。与C组相比,IS组和EI组的线粒体超微结构变化不明显。
我们的结果表明,在兔子中,静脉注射乳化异氟醚对缺血再灌注损伤提供的心肌保护与吸入异氟醚相似。