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狗在降钙素基因相关肽诱导的低血压期间,伴或不伴普萘洛尔时的内脏器官血流情况。

Splanchnic organ blood flow during calcitonin gene-related peptide-induced hypotension with or without propranolol in dogs.

作者信息

Takeda S, Tomaru T, Inada Y

机构信息

Department of Anesthesiology, Showa University Fujigaoka Hospital, Yokohama, Japan.

出版信息

Anesth Analg. 2000 Jun;90(6):1275-80. doi: 10.1097/00000539-200006000-00004.

Abstract

UNLABELLED

Propranolol has been used to attenuate reflex tachycardia during induced hypotension. The purpose of the current study was to determine whether propranolol can modify splanchnic organ blood flow during calcitonin gene-related peptide (CGRP)-induced hypotension in dogs anesthetized with 1.3% isoflurane in oxygen. After surgical preparation and hemodynamic stabilization, saline as a control, 0.5 mg/kg and 2.0 mg/kg propranolol (n = 10, each) were administered in a bolus injection 20 min before hypotension was induced. Mean arterial pressure was reduced to 60 mm Hg during 60 min of CGRP infusion. Renal blood flow (RBF), hepatic blood flow (HBF), and pancreatic blood flow (PBF) were measured using the hydrogen clearance method. Cardiac index did not change in all three groups, and heart rate in the control group remained unchanged. In the propranolol groups, however, heart rate decreased (P < 0.01). Plasma norepinephrine (NE), but not epinephrine (E), increased (P < 0.05) after propranolol administration. The NE and E increased (P < 0.01) during induced hypotension in all three groups. NE was higher in the 0.5 mg/kg propranolol group than in the control group. RBF in the control group remained unchanged throughout observation. RBF, HBF, and PBF decreased (P < 0.01) after propranolol and remained decreased during and after induced hypotension. The degrees of decreased HBF and PBF in the control group were less than those in the 2.0 mg/kg propranolol group. In conclusion, pretreatment with propranolol decreases splanchnic organ blood flow further during CGRP-induced hypotension, due in part to increased plasma catecholamine concentrations.

IMPLICATIONS

The reductions in splanchnic organ blood flows during CGRP-induced hypotension with propranolol are due to a reflex augmentation in sympathetic vasoconstrictor tone caused by an increase in plasma catecholamine concentrations. These findings suggest that propranolol may impair splanchnic organ blood flow during CGRP-induced hypotension.

摘要

未标注

普萘洛尔已被用于在诱导性低血压期间减轻反射性心动过速。本研究的目的是确定在以1.3%异氟醚加氧气麻醉的犬中,普萘洛尔在降钙素基因相关肽(CGRP)诱导的低血压期间是否能改变内脏器官血流。在手术准备和血流动力学稳定后,在诱导低血压前20分钟静脉推注生理盐水作为对照、0.5mg/kg和2.0mg/kg普萘洛尔(每组n = 10)。在输注CGRP的60分钟内,平均动脉压降至60mmHg。使用氢清除法测量肾血流量(RBF)、肝血流量(HBF)和胰腺血流量(PBF)。三组的心脏指数均未改变,对照组的心率保持不变。然而,在普萘洛尔组中,心率下降(P < 0.01)。给予普萘洛尔后,血浆去甲肾上腺素(NE)升高(P < 0.05),但肾上腺素(E)未升高。在所有三组诱导性低血压期间,NE和E均升高(P < 0.01)。0.5mg/kg普萘洛尔组的NE高于对照组。对照组的RBF在整个观察期间保持不变。给予普萘洛尔后,RBF、HBF和PBF下降(P < 0.01),并在诱导性低血压期间及之后持续下降。对照组HBF和PBF的下降程度小于2.0mg/kg普萘洛尔组。总之,普萘洛尔预处理在CGRP诱导的低血压期间进一步降低内脏器官血流,部分原因是血浆儿茶酚胺浓度升高。

启示

普萘洛尔在CGRP诱导的低血压期间内脏器官血流减少是由于血浆儿茶酚胺浓度升高引起的交感缩血管张力反射性增强。这些发现表明,普萘洛尔可能在CGRP诱导的低血压期间损害内脏器官血流。

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