Alper C M, Ardic F N, Doyle W J
Department of Pediatric Otolaryngology, Children's Hospital of Pittsburgh, PA 15213, USA.
Auris Nasus Larynx. 2000 Apr;27(2):105-11. doi: 10.1016/s0385-8146(99)00053-x.
To determine if middle ear (ME) gas composition and/or total pressure regulates local mucosal blood flow (MBF) and vascular permeability. The hypotheses tested are: (1) relatively high local CO2 tensions and/or low O2 tensions increase the ME MBF and vascular permeability; and (2) sub-atmospheric total ME pressure provokes similar effects.
The responses of ME MBF and vascular permeability parameters were measured during 60 min exposures of chinchilla MEs to one of two test gas mixtures (16.3% O2, 5.1% CO2, balance N2, or 5.3% O2, 15.6% CO2, balance N2) applied at different levels of underpressure (ref. ambient). In the first set of experiments (n = 19), mucosal perfusion parameters were recorded using a Laser Doppler Flowmeter for 60 min before and 60 min after exposure to the experimental conditions. In the second set of experiments (n = 19 chinchillas, 38 ears), the MEs were exposed to the gas mixtures and then maintained for 60 min at ambient pressure or at negative pressures of -200, -400, -600 mmH2O. Fifty minutes into the experiment, the animals were injected intravenously with 60 mg/kg of horseradish peroxidase (HRP). The animals were killed and existing effusion was aspirated, its volume recorded and then analyzed for total protein. From surface preparations of the ME mucosa, vascular leakage sites were measured as percent total surface area using an image analysis program with the threshold window set to discriminate HRP stain.
Throughout the 120 min in the first set of experiments, the measured MBF parameters decreased in all exposure groups. Comparisons among groups for the absolute magnitude of the change from baseline showed that high local CO2 partial pressures decreased MBF and ME underpressures increased MBF, but the effects did not achieve statistical significance. The results of the second set of experiments demonstrated no effect of gas composition on any of the measured parameters of vascular permeability. All measures of permeability were linearly related to the magnitude of the underpressure.
These data support a role for total ME pressure, but not CO2 partial pressure in regulating ME MBF and vascular permeability.
确定中耳(ME)气体成分和/或总压力是否调节局部黏膜血流(MBF)和血管通透性。所检验的假设为:(1)相对较高的局部二氧化碳张力和/或较低的氧气张力会增加中耳MBF和血管通透性;(2)低于大气压的中耳总压力会产生类似的效果。
在将两种测试气体混合物(16.3%氧气、5.1%二氧化碳,其余为氮气,或5.3%氧气、15.6%二氧化碳,其余为氮气)之一以不同负压水平(参考环境压力)施加于龙猫中耳60分钟的过程中,测量中耳MBF和血管通透性参数的反应。在第一组实验(n = 19)中,在暴露于实验条件之前和之后60分钟,使用激光多普勒血流仪记录黏膜灌注参数60分钟。在第二组实验(n = 19只龙猫,38只耳朵)中,将中耳暴露于气体混合物中,然后在环境压力或 -200、-400、-600 mmHg2O的负压下维持60分钟。实验进行到50分钟时,给动物静脉注射60 mg/kg的辣根过氧化物酶(HRP)。处死动物并吸出存在的积液,记录其体积,然后分析总蛋白。从中耳黏膜的表面制剂中,使用图像分析程序将血管渗漏部位测量为总表面积的百分比,阈值窗口设置为区分HRP染色。
在第一组实验的整个120分钟内,所有暴露组中测量的MBF参数均下降。各实验组与基线相比变化的绝对幅度比较显示,高局部二氧化碳分压降低MBF,中耳负压增加MBF,但这些影响未达到统计学意义。第二组实验的结果表明,气体成分对任何测量的血管通透性参数均无影响。所有通透性测量值均与负压大小呈线性相关。
这些数据支持中耳总压力在调节中耳MBF和血管通透性方面的作用,但不支持二氧化碳分压的作用。