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氯胺酮在肝脏缺血再灌注损伤中的剂量依赖性抗炎作用

Dose-Dependent Anti-Inflammatory Effect of Ketamine in Liver Ischemia-Reperfusion Injury.

作者信息

Gundogdu Zafer, Demirel Ismail, Bayar Mustafa Kemal, Ozkan Zeynep, Bayindir Serpil, Kocyigit Fatma, Hanbeyoglu Onur, Kahraman Mustafa

出版信息

Middle East J Anaesthesiol. 2016 Oct;23(6):655-663.

Abstract

INTRODUCTION

Hepatic ischemia-reperfusion (I/R) injury is commonly observed in severe sepsis, hemorrhagic shock, liver transplantation, hepatic resection, and major trauma. Ketamine suppresses the production of cytokines, such as IL-6 and TNF-α, via NF-κB inhibition. We investigated the anti-inflammatory effects of ketamine in liver I/R injury.

MATERIALS AND METHODS

Female Wistar-Albino rats (n = 18), weighing 150-200g, were divided into three groups (n = 6 each). Group I underwent reperfusion for 4h following 30 min of ischemia. Group II received 2.5 mg/kg ketamine IM following 30 min of ischemia and 4h of reperfusion and Group III received 10 mg/kg ketamine IM following 30 min of ischemia and 4h of reperfusion. Blood samples were obtained before and after ischemia and reperfusion. MDA, AST, ALT, TNF-α, IL-1β, IL-6, and NO levels were determined. Liver tissue samples were evaluated histologically.

RESULTS

Increased TNF-α, IL-1β, and IL-6 levels were observed in all groups post-ischemia versus pre-ischemia (p <0.05). The TNF-α, IL-1β, and IL-6 levels in Group III increased less than they did in Groups I and II (p <0.05). Higher MDA, NO, AST, and ALT levels were found during the ischemia and reperfusion periods compared with during the pre-ischemia period in all groups (p <0.05). The MDA, NO, AST, and ALT levels of rats that received ketamine increased less than did those of Group I (p <0.05). Significantly less injury was observed in the histopathological analysis of livers of rats administered ketamine (p <0.05).

CONCLUSIONS

Ketamine showed a dose-dependent anti-inflammatory effect in I/R injury in the liver when administered after ischemia.

摘要

引言

肝缺血再灌注(I/R)损伤常见于严重脓毒症、失血性休克、肝移植、肝切除及重大创伤。氯胺酮通过抑制核因子κB(NF-κB)来抑制细胞因子如白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)的产生。我们研究了氯胺酮在肝I/R损伤中的抗炎作用。

材料与方法

体重150 - 200g的雌性Wistar - Albino大鼠(n = 18)分为三组(每组n = 6)。第一组在缺血30分钟后进行4小时的再灌注。第二组在缺血30分钟和再灌注4小时后肌肉注射2.5mg/kg氯胺酮,第三组在缺血30分钟和再灌注4小时后肌肉注射10mg/kg氯胺酮。在缺血和再灌注前后采集血样。测定丙二醛(MDA)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、TNF-α、白细胞介素-1β(IL-1β)、IL-6和一氧化氮(NO)水平。对肝组织样本进行组织学评估。

结果

与缺血前相比,所有组缺血后TNF-α、IL-1β和IL-6水平均升高(p <0.05)。第三组的TNF-α、IL-1β和IL-6水平升高幅度小于第一组和第二组(p <0.05)。与缺血前相比,所有组在缺血和再灌注期间MDA、NO、AST和ALT水平更高(p <0.05)。接受氯胺酮的大鼠的MDA、NO、AST和ALT水平升高幅度小于第一组(p <0.05)。在给予氯胺酮的大鼠肝脏组织病理学分析中观察到的损伤明显更少(p <0.05)。

结论

缺血后给予氯胺酮在肝I/R损伤中显示出剂量依赖性抗炎作用。

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