脊髓背角p38MAPK活化在瑞芬太尼诱发术后痛觉过敏中的作用-论文.pdf

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1、·620·中国疼痛瞑学杂志ChineseJournalofPainMedicine2014。2O(9doi：10．3969~．issn．1006-9852．2014．09．004脊髓背角p38MAPK活化在瑞芬太尼诱发术后痛觉过敏中的作用术张丽华侯蕾娜邓立琴辛婧媛宋凤香吴鹏(宁夏医科大学，银川750004；宁夏医科大学总医院麻醉科，银川750004)摘要目的：探讨脊髓背角磷酸化p38丝裂原活化蛋白激酶(p-p38MAPK)在瑞芬太尼诱发术后痛觉过敏中的作用。方法：取鞘内置管成功的雄性sD大鼠40只，体重230～270g，采用数字表

2、法将其随机分为5组：对照组(c组)、术后切口痛组(I组)、瑞芬太尼组(R组)、p38MAPK特异性抑制剂SB203580组(s组)和SB203580的溶媒二甲基亚砜DMSO组(D组)。C组、I组、R组大鼠鞘内分别给予Nsl01，s组和D组大鼠鞘内分别给予2．65mrnolSB20358010l和溶剂2％DMSO101；I组大鼠在1．5％异氟烷吸入麻醉下行右侧跖底切口手术，C组大鼠不行右侧跖底手术，其余三组均在瑞芬太尼持续泵注下行右侧跖底切开手术。采用热辐射刺激仪和yonFrey纤维丝分别测定双侧后爪热刺激缩爪潜伏期及机械性痛阈。应

3、用免疫组织化学法检测脊髓背角p-p38MAPK表达的变化。结果与I组比较，R组、D组在术后4h、1d、2d、3d双侧跖底热刺激缩爪潜伏期、机械性痛阈值均降低，双侧脊髓背角p-p38MAPK表达增多；与R组比较，s组双侧跖底的机械性痛阈值、手术侧跖底热刺激缩爪潜伏期值增高，双侧脊髓背角p-p38MAPK表达减少。结论：脊髓背角p38MAPK活化可能参与了瑞芬太尼诱发的术后痛觉过敏。关键词p38丝裂原活化蛋白激酶；痛觉过敏；瑞芬太尼；脊髓背角THEROLEOFp38MAPKACTIVATIONINSPINALCORDDORSALHOR

4、NINREMINFENTANILINDUCEDPOSTOPERATIVEHYPERALGESIA*ZHANGLi-Hua，HOULei—Na，DENGLi·Qin，XINJing-Yuan，SongFeng—Xiang，WUPeng(NingxiaMedicalUniversity,Yinchuan750004；DepartmentofAnesthesiology,GeneralHospitalofNingxiaMedicalUniversity,Yinchuan750004)AbstractObjective：Toinvesti

5、gatetheroleofp38MAPKactivationinthespinalcorddorsalhorninremifentanilinducedpostoperativehyperalgesia．Methods：FortyadultmaleSpragueDawleyratsinwhichintrathecalcatheterswereimplantedsuccessfullBweighing230～270g，wererandomlydividedinto5groups：controlgroup(groupC)，incisi

6、onpainafteroperationgroup(groupI)，remifentanilgroup(groupR)，p38MAPKinhibitorSB203580group(groupS)andthesolventDMSO(groupD)．NS10lweregivenintrathecallyingroupC，groupIandgroupR，respectively,while2．65mmolSB203580101or2％DMSO10lwereinjectedintrathecallyingroupSandgroupD，re

7、spectively~IngroupI，theplantarincisionsurgeryoftherighthindpawwasperformedunder1．5％isofluraneanesthesia．whilethesurgerywasnotperformedingroupC．Therestgroupswereperformedthesamesurgerywithremifentanilinfusedconstantly．RadiantheatmethodandyonFreyfilamentswereappliedtote

8、stthermalpawwithdrawallatency(PWL)andmechanicalpawwithdrawalthreshold(PWT)．p-p38MAPKpositivecellsinthespinalcorddorsalhornwe