我们的网站为什么显示成这样?

可能因为您的浏览器不支持样式,您可以更新您的浏览器到最新版本,以获取对此功能的支持,访问下面的网站,获取关于浏览器的信息:

|本期目录/Table of Contents|

丙泊酚对老年患者外周血淋巴细胞上β1肾上腺素能受体脱敏的影响

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2010年第1期
页码:
107-110
栏目:
临床研究
出版日期:
2010-01-04

文章信息/Info

Title:
Role of propofol in peripheral lymphocytic β1 adrenergic receptor desensitization in elderly patients
作者:
吴坛光吴晓智陈国忠刘韧林剑清
南京军区福州总医院麻醉科,福建 福州 350025
Author(s):
WU Tan-guang WU Xiao-zhi CHEN Guo-zhong LIU Ren LIN Jian-qing
Department of Anesthesiology, Fuzhou General Hospital, Nanjing Military Area Command, Fuzhou 350025, Fujian, China
关键词:
丙泊酚淋巴细胞β1肾上腺素能受体脱敏
Keywords:
propofol peripheral lymphocytes β1 adrenergic receptor desensitization
分类号:
R614.2
DOI:
-
文献标识码:
A
摘要:
目的: 观察丙泊酚单次静脉给药对老年患者外周血淋巴细胞β1肾上腺素能受体(β1-AR)脱敏的影响,并探讨其循环抑制机制。方法: 选择拟在全麻下施行择期手术治疗的老年患者30例,随机分为3组(n=10),即低剂量组(L组):给予丙泊酚1.0 mg/kg,高剂量组(H组):给予丙泊酚2.0 mg/kg和对照组(C组):给予生理盐水。均在全麻诱导前,静脉单次注射给药。给药前后3 min,记录收缩压(SBP)、舒张压(DBP)和心率(HR)的变化,同时抽取外周静脉抗凝血各15 ml,经Boyum法分离淋巴细胞后,用Western blot分别检测总蛋白、胞膜和胞质蛋白中β1-AR的表达;用放射免疫法检测异丙肾上腺素刺激的淋巴细胞内cAMP的含量。结果: 与C组比较,L组和H组给药后均可降低SBP,DBP,淋巴细胞内cAMP含量及胞膜β1-AR蛋白的水平(P<0.05或P<0.01);但胞质β1-AR蛋白的水平增加(P<0.05或P<0.01)。H组的上述指标降低或增加的幅度均较L组明显(P<0.05)。组间两两比较,淋巴细胞总蛋白中β1-AR的水平无显著差别。结论: 丙泊酚可引起老年患者剂量依赖外周血淋巴细胞上β1-AR脱敏,与丙泊酚可促进β1-AR由胞膜内化进入胞质有关。
Abstract:
AIM: To evaluate the role of propofol in peripheral lymphocytic β1 adrenergic receptor (AR) desensitization in elderly patients. METHODS: Thirty elderly patients were recruited into the study and were classified into three groups (n=10): low-dose group (L) with propofol (1.0 mg/kg), high-dose group (H) with propofol (2.0 mg/kg) and control group (C). Lymphocytes were isolated and expressions of β1-AR in cytoplasm and cytomembrane were detected with Western blot. Isoproterenol-stimulated cAMP products in lymphocytes were measured with radioimmunoassay. Before and after injection, blood pressure (BP) and heart rate (HR) were also recorded. RESULTS: Systolic blood pressure (SBP), diastolic blood pressure (DBP), cAMP product and β1-AR level in lymphocytic cytomembrane in the L group and H group were all lower than in the control group (P<0.05 or P<0.01). On the contrary, β1-AR protein level in lymphocytic cytomembrane in the L group and H group was significantly more abundant than in the control group (P<0.05 or P<0.01). CONCLUSION: Clinically relevant concentrations of propofol attenuate -adrenergic signal transduction in peripheral lymphocytes via promotion to the internalization of β1-AR and inhibition of cAMP production, which may be a contributory factor in cardiac vascular inhibition.

参考文献/References

[1] 林财珠,张永洪,林健清, 等. 丙泊酚对自发性高血压大鼠心肌β-肾上腺素能受体、腺苷酸环化酶的影响[J]. 临床麻醉学杂志, 2003, 19(4):228-230.

[2] Tilley DG, Rockman HA. Role of β-adrenergic receptor signaling and desensitization in heart failure: new concepts and prospects for treatment[J]. Expert Rev Cardiovasc Ther, 2006, 4(3):417-432.

[3] Byum A. Isolation of mononuclear cells and granulocytes from human blood. Isolation of monuclear cells by one centrifugation, and of granulocytes by combining centrifugation and sedimentation at 1 g[J]. Scand J Clin Lab Invest Suppl, 1968, 97:77-89.

[4] 冯作化. 医学分子生物学[M]. 北京:人民卫生出版社, 2005:131-133.

[5] 劳宁,徐礼鲜,聂煌,等. 全身麻醉中异丙酚对循环抑制作用机制的研究[J]. 心脏杂志, 2008, 20(1):24-27.

[6] Uchida M, Iida H, Osawa Y, et al. Clonidine attenuates the hemodynamic responses to hypercapnia during propofol anesthesia[J]. Can J Anesth, 2004, 51(2):188-189.

[7] Kurokawa H, Murray PA, Damron DS. Propofol attenuates beta-adrenoreceptor -mediated signal transduction via a protein kinase C-dependent pathway in cardiomyocytes[J]. Anesthesiology, 2002, 96(3):688-698.

[8] Yu XY, Lin SG, Wang XM, et al. Evidence for coexistence of three beta-adrenoceptor subtypes in human peripheral lymphocytes[J]. Clin Pharmacol Ther, 2007, 81(5):654-658.

备注/Memo

备注/Memo:
收稿日期:2008-5-15.基金项目:南京军区福州总医院院内课题基金项目资助(200731) 通讯作者:陈国忠,教授,主要从事围术期心肌保护研究Email:Cgzssq2000@sina.com 作者简介:吴坛光,主治医师,硕士Email:wutanguang@126.com 现工作单位:武汉解放军第161中心医院麻醉科
更新日期/Last Update: 2010-01-05