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心筋虚血再灌流障害に対するセボフルランによる抑制効果―投与方法による比較検討― Inhibitory effects of sevoflurane on myocardial ischemia/reperfusion injury.－A comparative study with various sevoflurane administrations － 髙田, 一毅 タカダ, カズキ Takada, Kazuki 髙田 タカダ Takada 一毅 カズキ Kazuki open access セボフルラン 心筋保護 虚血再灌流障害 sevoflurane cardioprotection ischemia/reperfusion injury 2014 application/pdf 心筋虚血再灌流ウサギモデルにおいて，心筋壊死縮小効果をもたらすセボフルランの投与方法を検討した。ケタミン/ザイラジン（K/X）で麻酔したコントロール群，さらに1.5%セボフルランを持続投与した群（K/X+1.5S群），2.1%セボフルランの持続投与群（2.1S群），1.5%セボフルランでプレコンディショニングを行った群（Pre群），ポストコンディショニングを行った群（Post群）に分類し，虚血再灌流を行った。心筋梗塞域/虚血域のサイズからコントロール群に比べ他の4群では虚血再灌流後の心筋壊死縮小効果が有意に大きかった。またPre群とPost群の虚血再灌流後の心筋壊死縮小効果は2.1S群に比べて有意に大きかった。プレコンディショニング，ポストコンディショニングは心筋保護効果がほぼ同等の強さであることが示唆された。 This study was designed to investigate the cardioprotective effects of different ways of sevoflurane administration on myocardial ischemia/reperfusion injury in in vivo rabbit hearts. Rabbits underwent regional ischemia by 30 min of the left anterior descending artery (LAD) occlusion followed by 180 min of reperfusion. Control group, Ketamine/Xylazine (K/X)+1.5S group and 2.1% sevoflurane group (2.1S), received K/X anesthesia, continuous 1.5% sevoflurane under K/X, and continuous 2.1% sevoflurane only, respectively. The Pre group animals received sevoflurane (1.5 %) for 5 min prior to ischemia under K/X. Post group animals received sevoflurane (1.5 %) for 5 min after reperfusion under K/X. Infarct size/risk area was 59.9±1.9 % in the Control group；the size was decreased significantly to 42.6±5.4% in the K/X+1.5S group, 47.3±1.0% in the 2.1S group, and 35.6±1.2% in the Pre group and 32.5±6.1% in the Post group. Mean infarct size of the risk area was significantly less in the Pre group and the Post group than the 2.1S group. These results suggest that 1.5%sevoflurane preconditioning and postconditioning cause the almost same potent infarct size limiting effect in the myocardium in the rabbits. It was suggested sevoflurane postconditioning may be clinically applicable in situations where the potential for ischemia/reperfusion injury is of concern. The Japanese Society of Reanimatology jpn doctoral thesis VoR https://kdu.repo.nii.ac.jp/records/12 蘇生, 33(2):63-68, 2014 https://www.jstage.jst.go.jp/article/jjreanimatology/33/2/33_63/_article/-char/ja/ J-STAGE 乙第496号 博士（歯学） 2014-09-18 32703 神奈川歯科大学 https://kdu.repo.nii.ac.jp/record/12/files/otsu496_fulltext.pdf application/pdf 2.4 MB 2021-03-15 https://kdu.repo.nii.ac.jp/record/12/files/otsu496_summary.pdf application/pdf 126.1 kB 2016-04-07 https://kdu.repo.nii.ac.jp/record/12/files/otsu496_thesisreview.pdf application/pdf 153.2 kB 2016-04-07