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腹主动脉上阻断和解除阻断大鼠模型中的全身及肠系膜血流动力学、代谢和肠道张力测定

Systemic and mesenteric hemodynamics, metabolism, and intestinal tonometry in a rat model of supraceliac aortic cross-clamping and declamping.

作者信息

Wu X, Siegemund M, Seeberger M, Studer W

机构信息

Department of Anesthesia and Research, University of Basel, Switzerland.

出版信息

J Cardiothorac Vasc Anesth. 1999 Dec;13(6):707-14. doi: 10.1016/s1053-0770(99)90125-8.

Abstract

OBJECTIVE

To describe systemic and mesenteric hemodynamics, metabolism, and intestinal tonometry in a rat model of supraceliac aortic cross-clamping and declamping.

DESIGN

Prospective, randomized, experimental study.

SETTING

University cardiovascular research laboratory.

PARTICIPANTS

Twelve male anesthetized and ventilated Sprague-Dawley rats.

INTERVENTION

Supraceliac aortic cross-clamping was performed for 30 minutes, followed by declamping and reperfusion for 180 minutes or sham clamping and sham declamping.

MEASUREMENTS AND MAIN RESULTS

Mean arterial blood pressure; abdominal aortic, superior mesenteric, and carotid artery blood flow; intestinal mucosal tonometry; hemoglobin; lactate; and blood gases were measured before and after 30 minutes of aortic cross-clamping and 15, 30, 60, 120, and 180 minutes after declamping during reperfusion. Aortic cross-clamping induced an increase in mean arterial pressure (117+/-20 mm Hg to 147+/-12 mm Hg), an increase in right atrial hemoglobin saturation(66%+/-11% to 81%+/-6%), an increase in lactate levels (1.7+/-0.7 mmol/L to 4.3+/-1.3 mmol/L), and an increase in tonometric PCO2 (49.6+/-5.0 mm Hg to 75.6+/-8.6 mm Hg). Three hours of reperfusion after declamping resulted in significantly decreased mean arterial pressure (38+/-10 mm Hg); decreased aortic (101+/-12 mL/min/kg to 57+/-32 mL/min/kg), mesenteric (19+/-4 to 13+/-6 mL/min/kg), and carotid (12+/-4 mL/min/kg to 5+/-3 mL/min/ kg) blood flows; and elevated lactate levels (4.2+/-2.0 mmol/L). Tonometric PCO2 had normalized to baseline levels (51.9+/-3.8 mm Hg), but PCO2 gap was significantly higher than in sham clamped rats (17.9+/-7.8 mm Hg v. 7.0+/-2.6 mm Hg).

CONCLUSIONS

Hemodynamic and metabolic effects of aortic cross-clamping and declamping known from large animal models are reproducible using a rat model. Intestinal tonometry indicated mesenteric ischemia during aortic cross-clamping, which was reversible to preclamp values within 30 minutes of reperfusion after declamping.

摘要

目的

描述腹主动脉上阻断和解除阻断大鼠模型中的全身及肠系膜血流动力学、代谢和肠张力测定情况。

设计

前瞻性、随机、实验性研究。

地点

大学心血管研究实验室。

研究对象

12只麻醉并机械通气的雄性Sprague-Dawley大鼠。

干预措施

进行腹主动脉上阻断30分钟,随后解除阻断并再灌注180分钟,或进行假阻断和假解除阻断。

测量指标及主要结果

在主动脉阻断30分钟前后以及解除阻断后再灌注期间的15、30、60、120和180分钟测量平均动脉血压、腹主动脉、肠系膜上动脉和颈动脉血流量、肠黏膜张力测定、血红蛋白、乳酸和血气。主动脉阻断导致平均动脉压升高(从117±20 mmHg升至147±12 mmHg)、右心房血红蛋白饱和度升高(从66%±11%升至81%±6%)、乳酸水平升高(从1.7±0.7 mmol/L升至4.3±1.3 mmol/L)以及张力测定PCO₂升高(从49.6±5.0 mmHg升至75.6±8.6 mmHg)。解除阻断后3小时再灌注导致平均动脉压显著降低(38±10 mmHg);腹主动脉(从101±12 mL/min/kg降至57±32 mL/min/kg)、肠系膜上动脉(从19±4降至13±6 mL/min/kg)和颈动脉(从12±4 mL/min/kg降至5±3 mL/min/kg)血流量降低;乳酸水平升高(4.2±2.0 mmol/L)。张力测定PCO₂已恢复至基线水平(51.9±3.8 mmHg),但PCO₂差值显著高于假阻断大鼠(17.9±7.8 mmHg对7.0±2.6 mmHg)。

结论

使用大鼠模型可重现大型动物模型中已知的主动脉阻断和解除阻断的血流动力学及代谢效应。肠张力测定表明主动脉阻断期间肠系膜缺血,解除阻断后再灌注30分钟内可恢复至阻断前值。

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