目的:探讨吗啡预处理对兔心肌缺血再灌注损伤的延迟相保护作用机制.方法:30只雄性新西兰大白兔随机分成3组:假手术组、缺血再灌注组(I/R组)、吗啡组,每组10只.假手术组仅行左冠脉套线而不阻断160 min,I/R组行左冠状动脉前降支阻断40 min,再灌注120 min,吗啡组静注吗啡1.0 mg/kg,24 h后处理同I/R组.再灌注结束后抽血测超氧化物歧化酶(SOD)活性和丙二醛(MDA)含量,观察心肌超微结构,测心梗面积和热休克蛋白-27(HSP27)的表达.结果:与I/R组比,吗啡降低心肌梗死面积,上调HSP27表达和SOD活性,降低MDA含量,改善细胞超微结构.结论:吗啡预处理可能通过HSP27对兔心肌产生延迟相保护作用,其机制与HSP27抗过氧化损伤有关.
Objective: To investigate the protective effects of preconditioning morphine on rabbit myocardium during ischemia-reperfusion. Methods: Thirty New Zealand male white rabbits were randomly assigned to three groups:control,I/R and morphine groups.In morphine group 1.0 mg/kg morphine was given preoperationaly,in control and I/R groups 1.0 ml/kg NS was given.Twenty-four hours later rabbits in morphine and I/R groups underwent 40 min of coronary occlusion followed by 2 hours of reperfusion;for control group only sham operation was performed.At the end of the reperfusion,infarct size (IS) and area at risk (AAR) were defined by Evans blue and TTC staining.At the end of the reperfusion blood samples were taken for determination of plasma SOD activity and MDA levels.The heart was harvested and levels of the HSP27 were determined by Western blot,and the heart ultrastructures were observed under the electron microscopy. Results: Compared with I/R group,morphine significantly reduced infarct size (21.5%±2.4% vs 37.8%±1.7%,P<0.05).The morphine had a lower level of MDA and higher levels of SOD and HSP27 than those in I/R. Conclusion: Preconditioning of morphine demonstrates cardioprotective effect on ischemia/reperfusion injury,which may be associated with increased HSP27 levels in the heart.
卢向航，冉珂，徐军美，常业恬. 吗啡预处理对兔心肌缺血再灌注损伤的延迟相保护作用[J]. 浙江大学学报（医学版）, 2009, 38(4): 399-403.