【摘要】 目的 探讨不同剂量丙泊酚对内毒素血症兔心肌损害的保护作用及可能的机制。方法 通过连续注射内毒素复制内毒素血症动物模型。新西兰大白兔35只，雌雄不限，随机分为5组:正常对照组(A组)、内毒素对照组(B组)、内毒素并丙泊酚2mg/(kg·h)(C组)组、内毒素并丙泊酚5mg/(kg·h)组(D组)、内毒素并丙泊酚10mg/(kg·h)组(E组)。各丙泊酚治疗组均为内毒素注入后30min后予丙泊酚持续静脉泵入。300min内观察动物的动脉收缩压(SBP)，血清TNF-α,实验结束时取血测心肌肌钙蛋白浓度(cTnI)、心肌丙二醛(MDA)浓度。应用SPSS 11.0分析数据。结果 (1)内毒素对照组血压呈不可逆下降，而正常对照组血压没有明显改变，丙泊酚能有效缓解内毒素导致的血压下降；(2)给予内毒素300min后心肌MDA、cTnI，与A组比较B组显著升高(P<0.01)，与B组比较，C、D、E三组均能不同程度地逆转心肌MDA、cTnI的升高(P<0.01或0.05)，降低血清TNF-α水平。结论 早期、适量的丙泊酚对内毒素诱导的心肌损害可以起到一定的保护作用,其机制可能与丙泊酚抑制TNF-α生成、抑制体内脂质过氧化有关。

    【关键词】 脂多糖类；丙泊酚；肌钙蛋白；丙二醛；肿瘤坏死因子

    Protective effects of different dosage of propofol on endotoxininduced myocardial damage in rabbits

    WANG Yong,TU Su,SU Kai,et al.Department of Intensive Care Unit, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China

    【Abstract】 Objective To observe the protective effects of propofol in different doses on myocardial damage by endotoxin-induced in rabbits, and to determine the possible mechanism of protective effects of propofol to the myocardium.Methods Edotoxemia was replicated by receiving a continuous infusion of E. coli lipopolysacharide(LPS O111B4) in rabbits. Thirty-five New Zealand rabbits, male or female, were randomly divided into 5 groups. The groups including normal control group (group A),LPS control group(group B), LPS injection with propofol injection 2mg/(kg·h) group(group C), LPS injection with propofol injection 5mg/(kg·h) group(group D), LPS injection with propofol injection 10mg/(kg·h)group(group E) .In each propofol treatment group,rabbits received a continuous infusion of propofol for 30 min after intravenous LPS. The animals were observed for 300 min after LPS injection,and SBP,serum TNF-α level were recorded every hour. When the experiments were finished, the serum troponin I(cTnI) and myocardial MDA concentrations were measured. The data were statistics analyzed with SPSS 11.0.Results (1) Arterial blood pressure decreased continuously in LPS control group, however arterial blood pressure have no changes in normal control group. Propofol attenuated significantly the decrease in arterial blood pressure induced by LPS. (2) A significantly increased cTnI and MDA levels were found after LPS administration 300 minutes in group B, compared with group A (P<0.01). Compared with group B,propofol attenuated significantly the increase in serum cTnI , tumor necrosis factor-α,and myocardial MDA concentrations.Conclusion Propofol has a protective effect on myocardial damage endotoxin-induced in rabbits in early time,which may be linked with reduction in levels of TNF-α and inhibition of oxidative. ......