Alternative use of isoflurane and propofol confers superior cardioprotection than using one of them alone in a dog model of cardiopulmonary bypass
Alternative use of isoflurane and propofol confers superior cardioprotection than using one of them alone in a dog model of cardiopulmonary bypass
复制标题
在体外循环狗模型中，交替使用异氟醚和丙泊酚比单独使用其中一种具有更好的心脏保护作用
DOI：
10.1016/j.ejphar.2011.12.030
复制
发表时间：
2012-02-29
影响因子：
5
通讯作者：
Liu, Jin
中科院分区：
文献类型：
--
作者：
Li, Tao;Wu, Wei;Liu, Jin
我们先前的临床研究报告了异氟醚预适应和大剂量异丙酚后处理可减轻体外循环(CPB)手术患者的心肌缺血/再灌注损伤。本研究旨在通过犬体外循环模型来证实这种心脏保护作用，并阐明其相关机制。成年杂种雄性犬标准体外循环后随机分为4组：假手术组、异丙酚组、异氟醚组和异氟醚复合异丙酚组。诱导结束后，异丙酚组(异丙酚组)、异氟醚组(异氟醚组)或异氟醚预处理+异丙酚组(异丙酚组)维持麻醉。停跳2 h后，CPB结束，开放主动脉阻断，再灌注2 h。结果表明，异氟醚和异丙酚联合应用可促进心功能恢复，提高心肌氧利用率，减少心肌酶的释放。明显减轻缺血/再灌注损伤所致的氧化损伤。线性回归分析显示，心功能表现与氧化应激状态呈负相关，提示心功能的改善与氧化应激的减弱密切相关。此外，心脏耗氧量(VO2)与上述心功能和氧化应激参数显著相关，提示VO2可以预测心脏损伤和氧化应激的水平。因此，我们得出结论，交替使用异氟醚和异丙酚对缺血后心肌损伤和功能障碍具有良好的心脏保护作用，这种保护作用可能是通过减轻心脏氧化损伤而实现的。(C)2011爱思唯尔B.V.保留所有权利。
Our previous clinical study reported that isoflurane preconditioning and high-dose propofol posttreatment attenuated myocardial ischemia/reperfusion injury of patients in surgery with cardiopulmonary bypass (CPB). This study was designed to confirm this cardiac protection by use of a dog CPB model and to elucidate the related mechanism. Adult mongrel male dogs undergoing standard CPB were assigned into 4 groups: Sham group, Propofol group, Isoflurane (Iso) group and isoflurane in combination of propofol (pre-Iso+P) group. After induction, anesthesia was maintained with propofol (Propofol group), isoflurane (Iso group) or isoflurane preconditioning in combination with propofol posttreatment (pre-Iso+P group). After 2 h cardiac arrest and CPB, aortic cross-clamping was released to allow 2 h reperfusion. The results demonstrated that joint use of isoflurane and propofol facilitated cardiac functional recovery, improved myocardial oxygen utilization and decreased cardiac enzyme release. Also, the oxidative damage caused by ischemia/reperfusion injury was remarkably attenuated. Linear regression analysis showed that cardiac function performance and oxidative stress status were inversely correlated, indicating the improved cardiac function was in closed association with the attenuation of oxidative stress. In addition, the cardiac oxygen consumption (VO2) was found to be significantly associated with the above cardiac function and oxidative stress parameters, suggesting VO2 was predictive for the levels of cardiac damage and oxidative stress. Therefore, we conclude that alternative use of isoflurane and propofol confers superior cardioprotection against postischemic myocardial injury and dysfunction, and this protection was probably mediated by attenuation of cardiac oxidative damage. (C) 2011 Elsevier B.V. All rights reserved.