【摘要】 目的　观察芬太尼对离体灌流心脏收缩力及心肌细胞钙离子移动的影响，研究其对心肌收缩力的作用。方法　（１） 以含不同浓度芬太尼的克汉二氏重碳酸盐缓冲液（ＫＨＢ） 灌流大鼠心脏，测定心率（ＨＲ） 、左室收缩压（ＬＶＳＰ） 、左室舒张压（ＬＶＤＰ）、左室收缩压上升最大速率（ ＋ ｄｐ／ｄｔｍａｘ）、左室舒张压下降最大速率（ － ｄｐ／ｄｔｍａｘ） ；（２） 用Ｆｌｕｏ３ＡＭ 钙荧光指示剂染色急性分离的大鼠心肌细胞，在激光共聚焦显微镜下动态观察用药前和用不同浓度芬太尼后，ＫＣｌ 诱发的细胞内钙离子浓度的变化。结果　１ ｎｇ／ｍｌ 和２０ ｎｇ／ｍｌ 的芬太尼对心肌收缩力和心肌细胞钙离子移动的影响较小，心肌收缩力的各项指标和钙荧光强度与对照组相比，差异无显著性（ Ｐ＞ ０．０５） 。而２００ ｎｇ／ｍｌ 芬太尼使心率减慢及＋ ｄｐ／ｄｔｍａｘ 、－ ｄｐ／ｄｔｍａｘ下降，且差异有显著性（ Ｐ＜０ ．０５） 。结论　芬太尼对心肌细胞钙离子的跨膜内流影响较小，而使心肌收缩力保持稳定。超临床使用浓度的芬太尼仍有抑制心肌的趋势。更多还原

【Abstract】 Objective To investigate the effects of fentanyl on myocardial contractility and transsarcolemmal Ca  mobilizaton induced by KCl in rat myocytes. Methods (1) Heart Rate, left ventricular systolic pressure (LVSP), left ventricular diastolic pressure (LVDP), and myocardial contractility (+dp/dt max ,-dp/dt max ) were assessed in isolated rat heart perfused with KHB solution containing 1 ng/ml, 20 ng/ml, 200 ng/ml fentanyl, respectively. (2) Fresh isolated rat ventricular myocytes were stained with Fluo 3AM. The effects of 1 ng/ml, 20 ng/ml fentanyl on the change of intracellular Ca  concentration induced by KCl were investigated.Results Fentanyl, at the concentration of 1 ng/ml and 20 ng/ml did not change HR, LVSP, LVDP, +dp/dt max ,-dp/dt max as compared with those of the control. Though 200 ng/ml fentanyl did not change LVSP and LVDP, ±dp/dt max and HR decreased remarkably ( P <0.05). At the concentration of 1 ng/ml and 20 ng/ml, fentanyl did not inhibit Ca  transsarcolemmal influx. There was no statistical difference in the peak intracellular Ca  concentrations in all groups ( P >0.05).Conclusion Fentanyl at a concentration of 1 ng/ml, 20 ng/ml, produces no effects on myocardial contractility and Ca  transsarcolemmal influx, but at a surpraclinical concentration, it may have negative inotropic effect and decrease of HR.(Shanghai Med J, 2000,23∶5 7)更多还原