中文摘要：

目的评价瑞芬太尼预处理对大鼠肠缺血再灌注损伤的影响及其与阿片受体的关系。方法健康成年雄性SD大鼠72只，6-7周龄，体重250～280g，采用随机数字表法，将其分为9组（n=8）：假手术组（S组）、肠缺血再灌注组（I／R组）、瑞芬太尼预处理组（RP组）、不同阿片受体拮抗剂对照组（N组、BNI组和CTOP组）和阿片受体拮抗剂＋瑞芬太尼预处理组（N＋RP组、BNI＋RP组和CTOP＋RP组）。除S组外，其它8组采用阻断肠系膜上动脉1h再灌注2h的方法制备肠缺血再灌注损伤模型。瑞芬太尼预处理方法：缺血前以0．2μg·kg-1·min-1速率静脉输注瑞芬太尼5min，随后输注生理盐水5min，共3个循环；8受体拮抗剂纳曲吲哚（5mg／kg）、K受体拮抗剂nor-BNI（5mg／kg）和μ受体拮抗剂CTOP（1mg／kg）于瑞芬太尼预处理前静脉注射。再灌注2h时于心尖处采集血样，测定血清二胺氧化酶（DAO）活性，随后取肠组织，观察病理学结果，进行肠黏膜Chiu评分，测定肠黏膜上皮细胞凋亡指数和活化型caspase-3表达水平。结果与S组比较，I／R组和RP组血清DAO活性、肠黏膜Chiu评分和肠黏膜上皮细胞凋亡指数升高，活化型caspase-3表达上调（P〈0．05）；与I／R组比较，RP组、BNI＋RP组和CTOP组血清DAO活性、肠黏膜Chiu评分和肠黏膜上皮细胞凋亡指数降低，活化型caspase-3表达下调（P〈0．05），而N组、N＋RP组、BNI组和CTOP＋RP组上述指标比较差异无统计学意义（P〉O．05）；与RP组比较，N＋RP组和CTOP＋RP组血清DAO活性、肠黏膜Chiu评分和肠黏膜上皮细胞凋亡指数升高，活化型caspase-3表达上调（P〈O．05），BNI＋RP组上述指标比较差异无统计学意义（P〉0．05）。结论瑞芬太尼预处理可减轻大鼠肠缺血再灌注损伤，其机制与激活δ受体或μ受体介导的抗细胞凋亡有关，而与k受体无关。

英文摘要：

Objective To evaluate the effect of remifentanil preconditioning （RP） on intestinal is- chemia-reperfusion （I/R） injury in rats and its relationship with opioid receptors. Methods Seventy-two Sprague-Dawley rats, aged 6-7 weeks, weighing 250-280 g, were randomly divided to 9 groups （n = 8 each） ： sham operation group （S） , intestinal I/R group （group I/R） , RP group, different opioid receptor antagonists groups （N, BNI and CTOP groups） , and opioid receptor antagonists ＋ RP groups （N＋RP, BNI＋RP and CTOP＋RP groups）. Intestinal I/R was produced by clamping the superior mesenteric artery for 1 h followed by 2 h reperfusion in all the groups except group S. RP was induced by 3 cycles of 5 min infusion of remifentanil O. 2 μg · kg-1 · min -1 followed by 5 min infusion of normal saline before ischemia. Nahrindole （k-reeeptor antagonist, 5 mg/kg） , nor-binaltorphimine （K-receptor antagonist, 5 mg/kg） and CTOP （ μ-receptor antagonist, 1 mg/kg） were administered before RP. At 2 h of reperfusion, blood sam- ples were collected from the cardiac apex for determination of serum diamine oxidase （DAO） activity. Intes-tinal tissues were then removed for microscopic examination. Intestinal damage was assessed and scored ac- cording to Chiu. Apoptosis in intestinal mucosal epithelial cells was detected using TUNEL assay, and ap- optosis index was calculated. The expression of activated caspase-3 in intestinal mucosal epithelial cells was measured by Western blot. Results Compared with group S, the serum DAO activity, Chiu＇s score, and apoptosis index were significantly increased, and the expression of activated caspase-3 was up-regulated in I/R and RP groups （P〈0.05）. Compared with group I/R, the serum DAO activity, Chiu＇s score, and ap- optosis index were significantly decreased, and the expression of activated caspase-3 was down-regulated in RP, BNI＋RP and CTOP groups （P〈0.05） , and no significant change was found in the parameters men- tioned above in N