Wang C, Liu N, Li R-M, Zhang Y, Shen L, Xiong J-Y
Department of Anesthesiology, The Second Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China.
Laboratory of Molecular Biology, The Second Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China.
Genet Mol Res. 2015 May 11;14(2):4740-8. doi: 10.4238/2015.May.11.6.
The aim of this study was to determine the effect of etomidate and propofol pretreatment on the expression of glucocorticoid receptor and the prognosis of sepsis. The sepsis rat was used as a model. During glucocorticoid treatment, etomidate and propofol were applied alone or together at different time points. Survival curves, glucocorticoid receptor expression in the rat adrenal cortex, and inflammation levels were determined. The outcome of sepsis in rats was evaluated based on the combined utilization of propofol and etomidate. The results indicated that the combined utilization of propofol and etomidate pretreatment could significantly improve the effects of glucocorticoids on rat sepsis. Etomidate was shown to enhance the expression of the glucocorticoid receptor, while propofol was shown to inhibit the inflammatory response. Etomidate was best used immediately after modeling, whereas propofol was most suitable for use during the peak inflammatory reaction. These results demonstrated that anesthetics had the ability to enhance the effect of glucocorticoids in the treatment of sepsis. Etomidate was indicated for use in the early stage of inflammation to enhance expression of the glucocorticoid receptor, while propofol application was indicated at the peak of the inflammatory reaction owing to its strong anti-inflammation effect.
本研究的目的是确定依托咪酯和丙泊酚预处理对糖皮质激素受体表达及脓毒症预后的影响。以脓毒症大鼠作为模型。在糖皮质激素治疗期间,依托咪酯和丙泊酚在不同时间点单独或联合应用。测定生存曲线、大鼠肾上腺皮质中糖皮质激素受体的表达以及炎症水平。基于丙泊酚和依托咪酯的联合应用评估大鼠脓毒症的结局。结果表明,丙泊酚和依托咪酯预处理联合应用可显著改善糖皮质激素对大鼠脓毒症的治疗效果。依托咪酯可增强糖皮质激素受体的表达,而丙泊酚可抑制炎症反应。依托咪酯在建模后立即使用效果最佳,而丙泊酚最适合在炎症反应高峰期使用。这些结果表明,麻醉药具有增强糖皮质激素治疗脓毒症效果的能力。依托咪酯适用于炎症早期以增强糖皮质激素受体的表达,而丙泊酚因其强大的抗炎作用适用于炎症反应高峰期。