Dutton R, Levitzky M, Berkman R
Bull Eur Physiopathol Respir. 1976 Mar-Apr;12(2):265-73.
This study was designed to determine blood flow to the liver during hypercapnia and combined hypercapnia-hypoxia with the portal vein and hepatic artery intact except for placement of an electromagnetic flow probe around these vessels. Twenty mongrel dogs weighing 30-45 kg were anesthetized with pentobarbital and flow probes and occluders were surgically implanted. Ten of these dogs were subjected to hypercapnia alone. During inspiration of 6% CO2 in room air, portal vein flow increased from 588 +/- 73 ml/min to 731 +/- 113 ml/min (p less than .05), while hepatic artery flow did not change significantly from its control mean of 221 +/- 38 ml/min. In the remaining dogs, inhalation of 6% O2 resulted in a reduction of portal blood flow within 30 min from 527 +/- 55 ml/min to 381 +/- 41 ml/min (p less than .01). Again, mean hepatic artery flow did not increase significantly above its control of 273 +/- 43 ml/min. Subsequent inhalation of 6% CO2 plus 6% O2 (combined hypercapniahypoxia) for 30 min in these same animals resulted in a significant increase of portal vein blood flow from 514 +/- 46 ml/min to 716 +/- 116 ml/min (p less than .05). Thus, hypercapnia alone increases total liver blood flow, primarily by an increase in portal vein flow. Hypoxia results in a decrease in portal vein flow. The superimposition of hypercapnia on hypoxia restores blood flow to a level close to that found with hypercapnia alone. Hypercapnia in the range of 63 +/- 4 mmHg PCO2 overwhelms the tendency toward a reduction of portal vein blood flow induced by an arterial PO2 of 42 +/- 5 mmHg in the presence of mild hypocapnia (PCO2 : 30.2 +/- 1 mmHg).
本研究旨在确定在高碳酸血症以及高碳酸血症合并低氧血症期间肝脏的血流情况,此时门静脉和肝动脉保持完整,只是在这些血管周围放置了电磁血流探头。选用20只体重30 - 45千克的杂种犬,用戊巴比妥麻醉后,通过手术植入血流探头和闭塞器。其中10只犬单独接受高碳酸血症处理。在吸入含6%二氧化碳的室内空气时,门静脉血流从588±73毫升/分钟增加至731±113毫升/分钟(p<0.05),而肝动脉血流与对照均值221±38毫升/分钟相比无显著变化。其余犬吸入6%氧气后,30分钟内门静脉血流从527±55毫升/分钟降至381±41毫升/分钟(p<0.01)。同样,肝动脉平均血流与对照值273±43毫升/分钟相比无显著增加。随后,让这些犬吸入6%二氧化碳加6%氧气(高碳酸血症合并低氧血症)30分钟,门静脉血流从514±46毫升/分钟显著增加至716±116毫升/分钟(p<0.05)。因此,单独高碳酸血症主要通过增加门静脉血流来增加肝脏总血流量。低氧导致门静脉血流减少。在低氧基础上叠加高碳酸血症可使血流恢复至接近单独高碳酸血症时的水平。在轻度低碳酸血症(PCO2:30.2±1毫米汞柱)存在的情况下,63±4毫米汞柱PCO2范围内的高碳酸血症克服了动脉血氧分压42±5毫米汞柱所诱导的门静脉血流减少的趋势。