缺血预处理对异氟醚和七氟醚麻醉大鼠肝脏缺血/再灌注损伤的保护作用
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Reversal of Vecuronium-induced Neuromuscular Blockade with Low-dose Sugammadex at Train-of-four Count of Four
背景与目的
已经证明各种挥发性麻醉药和缺血预处理（IP）对肝脏的缺血/再灌注（I / R）损伤具有保护作用。我们的目的是明确在异氟烷和七氟醚麻醉下应用IP是否能够防止大鼠肝脏I / R损伤。
方 法
38只体重270〜300克的大鼠随机分为异氟醚组（1.5％）和七氟醚麻醉组（2.5％）。每组分为假手术组（n = 3），非IP组（n = 8; 45分钟肝缺血）和IP组（n = 8，长时间缺血前先进行10分钟缺血加15分钟再灌注）。比较再灌注后2h肝组织损伤程度和B细胞淋巴瘤2（Bcl-2）和caspase3的表达。
结 果
在异氟醚和七氟醚非IP组中，肝缺血均引起明显地I / R损伤。 在两个麻醉组中，IP显著减轻I / R损伤，其中明显地降低天冬氨酸转氨酶和转氨酶水平，与相应的非IP组相比，有更好的组织学等级。与相应的非IP组相比，异氟醚和七氟烷IP组的Bcl-2 mRNA水平分别增加2.3倍和1.7倍（均P <0.05）。异氟烷非IP组caspase 3水平显著高于假手术组; 然而，七氟醚组之间没有差异。
结 论
异氟醚和七氟醚组大鼠肝脏I / R损伤程度均明显高于对照组。 然而，IP对两个挥发性麻醉组的I / R损伤的保护程度相似，而Bcl-2的上调可能是一个重要的机制。
原始文献摘要
Jeong J S, Kim D, Kim K Y, et al. Ischemic Preconditioning Produces Comparable Protection Against Hepatic Ischemia/Reperfusion Injury Under Isoflurane and Sevoflurane Anesthesia in Rats.[J]. Transplantation Proceedings, 2017, 49(9):2188.
Abstract
BACKGROUND:
Various volatile anesthetics and ischemic preconditioning (IP) have been demonstrated to exert protective effect against ischemia/reperfusion (I/R) injury in liver. We aimed to determine whether application of IP under isoflurane and sevofluraneanesthesia would confer protection against hepatic I/R injury in rats.
METHODS:
Thirty-eight rats weighing 270 to 300 grams were randomly divided into 2 groups: isoflurane (1.5%) and sevoflurane (2.5%) anesthesia groups. Each group was subdivided into sham (n = 3), non-IP (n = 8; 45 minutes of hepatic ischemia), and IP (n = 8, IP consisting of 10-minute ischemia plus 15-minute reperfusion before prolonged ischemia) groups. The degree of hepatic injury and expressions of B-cell lymphoma 2 (Bcl-2) and caspase 3 were compared at 2 hours after reperfusion.
RESULTS:
Hepatic ischemia induced significant degree of I/R injuries in both isoflurane and sevoflurane non-IP groups. In both anesthetic groups, introduction of IP dramatically attenuated I/R injuries as marked by significantly lower aspartate aminotransferase and aminotransferase levels and better histologic grades compared with corresponding non-IP groups. There were 2.3- and 1.7-fold increases in Bcl-2 mRNA levels in isoflurane and sevoflurane IP groups, respectively, compared with corresponding non-IP groups (both P < .05). Caspase 3 level was significantly high in the isoflurane non-IP group compared with the sham group; however, there were no differences among the sevoflurane groups.
CONCLUSIONS:
The degree of hepatic I/R injury was significantly high in both isoflurane and sevoflurane groups in rats. However, application of IP significantly protected against I/R injury in both volatile anesthetic groups to similar degrees, and upregulation of Bcl-2 might be an important mechanism.
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