上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (1): 31-.doi: 10.3969/j.issn.1674-8115.2011.01.007

• 论著（基础研究） • 上一篇    下一篇

长时间大剂量输注丙泊酚致兔心肌损伤的实验研究

杨正波, 王 莉, 宦 乡, 江 伟   

  1. 上海交通大学 附属第六人民医院麻醉科, 上海 200233
  • 出版日期:2011-01-28 发布日期:2011-02-01
  • 通讯作者: 江 伟, 电子信箱: jiangw@sjtu.edu.cn。
  • 作者简介:杨正波（1983—）, 男, 硕士生；电子信箱: boboyang99@126.com。

Myocardial injury induced by prolonged high-dose propofol infusion in rabbits

YANG Zheng-bo, WANG Li, HUAN Xiang, JIANG Wei   

  1. Department of Anesthesiology, The Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China
  • Online:2011-01-28 Published:2011-02-01

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摘要：

目的 探讨机械通气状态下长时间大剂量输注丙泊酚对兔心肌损伤的作用。方法 健康雄性新西兰白兔18只，气管插管后随机分成丙泊酚组（P组，n=6）、异氟醚组（S组，n=6）和异氟醚+10%脂肪乳剂组（SI组，n=6）。P组输注丙泊酚，按照预先设定的镇静水平调节输注速度；S组和SI组吸入异氟醚，吸入浓度同样根据设定的镇静标准进行调节；SI组脂肪乳剂的输注速度和P组相同。实验时间持续36 h或至动物死亡。输注丙泊酚前及试验过程中分别在0、12、24、36 h时点采集股静脉血检测生化指标，实验结束取心肌组织进行免疫组织化学染色，检测肿瘤坏死因子α（TNF-α）的表达。结果 P组动物全部死亡，S和SI组动物存活时间均超过36 h。P组丙泊酚的最大输注速度为65 mg·kg-1·h-1。与S组及SI组相比，P组血压下降明显（P<0.05）。血生化指标检查显示：P组12、24和36 h时点的三酰甘油、谷草转氨酶、谷丙转氨酶、乳酸脱氢酶和肌酸激酶等指标水平均较0 h时点升高，差异有统计学意义（P<0.05）；且P组的肌酸激酶水平与S组和SI组相应时点比较，差异也有统计学意义（P<0.05）。P组心肌组织中的TNF-α表达量明显高于S组和SI组。结论 长时间大剂量输注丙泊酚可导致兔心肌组织损伤。

关键词: 丙泊酚, 机械通气, 输注综合征, 兔

Abstract:

Objective To investigate the effect of prolonged high-dose propofol infusion with mechanical ventilation on myocardial injury in rabbits. Methods Eighteen healthy New Zealand white rabbits were randomized into propofol group (group P, n=6), isoflurane group (group S, n=6) and isoflurane+10% Intralipid group (group SI, n=6) after tracheal intubation. Propofol was infused in group P, and the infusion velocity was adjusted to the desired sedation level. Isoflurane was inhaled in group S and group SI, and the inhalation concentration was also adjusted to the desired sedation level. The velocity of Intralipid infusion in group SI was the same as that of propofol infusion in group P. The experiment lasted for 36 h or till the animal death. Femoral venous blood samples were taken before propofol infusion and 0, 12, 24 and 36 h during experiment for examinations of biochemical parameters. Myocardial tissues were obtained after experiment for immunohistochemical staining, and the expression of tumor necrosis factor-α（TNF-α）was detected. Results All rabbits in group P were dead, while rabbits in the other two groups survived for at least 36 h. The maximum velocity of propofol infusion in group P was 65 mg·kg-1·h-1. Blood pressure in group P was significantly lower than that in group S and group SI (P<0.05). The levels of triglyceride, aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase and creatine kinase at the time points of 12 h, 24 h and 36 h were significantly higher than those at he time point of 0 h in group P (P<0.05). And there were significant differences in levels of creatine kinase between group P and group S or group SI at corresponding time points (P<0.05). The expression of TNF-α in myocardial tissues in group P was significantly higher than that in group S and group SI. Conclusion Prolonged high-dose propofol infusion may cause myocardial injury in rabbits.

Key words: propofol, mechanical ventilation, infusion syndrome, rabbit