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目的:观察瑞芬太尼预处理对大鼠短暂性全脑缺血再灌注损伤的影响。方法:38只大鼠随机分为5组:假手术组(n=6);缺血/再灌注前输注生理盐水组(n=8);瑞芬太尼2,6,20μg.kg-1.m in-1组(每组n=8);根据Sm ith等创建的“双侧颈总动脉阻断+低血压法”建立大鼠短暂性全脑缺血模型。瑞芬太尼在全脑缺血前30 m in由股静脉泵入,于双侧颈总动脉阻断前及开放后10 m in,从股动脉抽取0.5 mL血样,进行动脉血血气分析,于再灌注后3 d灌注取脑,并制作脑切片,HE染色,双盲法观察高倍镜下海马CA1、CA4区、纹状体、大脑皮层等脑区退变的神经细胞数,并计算出退变的神经锥体细胞的百分率。结果:各处理组生理参数变化差异无显著性;再灌注3 d后,生理盐水组及各瑞芬太尼预处理组出现显著的神经元损伤,与生理盐水组相比,芬瑞太尼6μg.kg-1.m in-1及芬瑞太尼20μg.kg-1m in.-1组海马CA1区退变的神经元较生理盐水组明显减少,各组CA4区未见明显的神经元退变细胞;再灌注3 d后,芬瑞太尼6μg.kg-1.m in-1及芬瑞太尼20μg.kg-1m in.-1组大脑皮层退变神经元较生理盐水组明显减少;与假手术组相比,生理盐水组及不同剂量的瑞芬太尼预处理较假手术组纹状体区退变神经元显著增多,但生理盐水组及各瑞芬太尼预处理组的差异无显著性。结论:瑞芬太尼预处理对全脑缺血再灌注后的神经元损伤具有保护作用。
Objective: To observe the effect of remifentanil preconditioning on transient global cerebral ischemia-reperfusion injury in rats. Methods: Thirty-eight rats were randomly divided into 5 groups: sham operation group (n = 6), saline infusion group before ischemia / reperfusion (n = 8), remifentanil (2,6 and 20 μg.kg- 1.m in-1 group (n = 8 for each group). A rat model of transient global cerebral ischemia was established by “bilateral carotid artery occlusion + hypotension” created by Smith et al. Remifentanil 30 min before the onset of global cerebral ischemia by the femoral vein parenchymal vein in the bilateral carotid artery occlusion and 10 m in the open after the extraction of 0.5 mL blood samples from the femoral artery for arterial blood gas analysis at The brain was perfused 3 days after reperfusion and brain sections were made. The number of degenerated neurons in the hippocampal CA1, CA4, striatum and cerebral cortex under high magnification was observed by HE staining and double-blind method. Change in the percentage of neuronal pyramidal cells. Results: There was no significant difference in the physiological parameters among the treatment groups. After 3 days of reperfusion, neuronal damage was found in the saline group and each remifentanil pretreatment group. Compared with the saline group, .kg-1.m in-1 and the fentanyl 20μg.kg-1m in.-1 hippocampal CA1 area degenerated neurons significantly reduced compared with the saline group, no significant neuronal withdrawal CA4 area in each group After 3 days of reperfusion, the degenerative neurons in the cerebral cortex of 6μg.kg-1.m in-1 and 20μg.kg-1m in.-1 of Fenretinal group were significantly decreased compared with the saline group Compared with the sham-operated group, the neurons in the saline group and the different doses of remifentanil significantly increased neurons in the striatum compared with the sham-operation group, while those in the saline group and the remifentanil preconditioning group No significant difference. Conclusion: Remifentanil preconditioning has a protective effect on neuronal injury after global cerebral ischemia and reperfusion.