论文部分内容阅读
目的 观察芬太尼对离体灌流心脏收缩力及心肌细胞钙离子移动的影响，研究其对心肌收缩力的作用。方法 （１） 以含不同浓度芬太尼的克汉二氏重碳酸盐缓冲液（ＫＨＢ） 灌流大鼠心脏，测定心率（ＨＲ） 、左室收缩压（ＬＶＳＰ） 、左室舒张压（ＬＶＤＰ）、左室收缩压上升最大速率（ ＋ ｄｐ／ｄｔｍａｘ）、左室舒张压下降最大速率（ － ｄｐ／ｄｔｍａｘ） ；（２） 用Ｆｌｕｏ３ＡＭ 钙荧光指示剂染色急性分离的大鼠心肌细胞，在激光共聚焦显微镜下动态观察用药前和用不同浓度芬太尼后，ＫＣｌ 诱发的细胞内钙离子浓度的变化。结果 １ ｎｇ／ｍｌ 和２０ ｎｇ／ｍｌ 的芬太尼对心肌收缩力和心肌细胞钙离子移动的影响较小，心肌收缩力的各项指标和钙荧光强度与对照组相比，差异无显著性（ Ｐ＞ ０．０５） 。而２００ ｎｇ／ｍｌ 芬太尼使心率减慢及＋ ｄｐ／ｄｔｍａｘ 、－ ｄｐ／ｄｔｍａｘ下降，且差异有显著性（ Ｐ＜０ ．０５） 。结论 芬太尼对心肌细胞钙离子的跨膜内流影响较小，而使心肌收缩力保持稳定。超临床使用浓度的芬太尼仍有抑制心肌的趋势。
Objective To observe the effect of fentanyl on contractile force of isolated perfused heart and the movement of calcium ion in myocardial cells and to study the effect of fentanyl on myocardial contractility. Methods (1) Rat heart was perfused with KHB containing different concentrations of fentanyl. Heart rate (HR), left ventricular systolic pressure (LVSP) and left ventricular diastolic pressure LVDP, + dp / dtmax and - dp / dtmax; (2) The acutely isolated rat cardiomyocytes were stained with Fluo3 AM calcium fluorescent indicator , Under dynamic confocal laser scanning microscope before treatment and with different concentrations of fentanyl, KCl-induced intracellular calcium concentration changes. Results Fentanyl at 1 ng / ml and 20 ng / ml had little effect on myocardial contractility and myocardial calcium transport. The indexes of myocardial contractility and calcium fluorescence intensity were not significantly different from those of the control group (P> 0.05). However, 200 ng / ml fentanyl slowed down the heart rate and decreased the dp / dtmax and dp / dtmax, respectively (P <0.05). Conclusion Fentanyl has little effect on the transmembrane influx of calcium in cardiomyocytes, but keeps the myocardial contractility stable. Fentanyl at supracrustal concentrations still has a tendency to inhibit myocardium.