全身动脉低灌注对猪内脏血流动力学及肝动脉缓冲反应的影响。
Effects of systemic arterial hypoperfusion on splanchnic hemodynamics and hepatic arterial buffer response in pigs.
作者信息
Jakob S M, Tenhunen J J, Laitinen S, Heino A, Alhava E, Takala J
机构信息
Critical Care Research Program, Department of Anesthesiology and Intensive Care, Kuopio University Hospital, FIN-70210 Kuopio, Finland.
出版信息
Am J Physiol Gastrointest Liver Physiol. 2001 May;280(5):G819-27. doi: 10.1152/ajpgi.2001.280.5.G819.
The hepatic arterial buffer response (HABR) tends to maintain liver blood flow under conditions of low mesenteric perfusion. We hypothesized that systemic hypoperfusion impairs the HABR. In 12 pigs, aortic blood flow was reduced by cardiac tamponade to 50 ml. kg(-1). min(-1) for 1 h (short-term tamponade) and further to 30 ml. kg(-1). min(-1) for another hour (prolonged tamponade). Twelve pigs without tamponade served as controls. Portal venous blood flow decreased from 17 +/- 3 (baseline) to 6 +/- 4 ml. kg(-1). min(-1) (prolonged tamponade; P = 0.012) and did not change in controls, whereas hepatic arterial blood flow decreased from 2 +/- 1 (baseline) to 1 +/- 1 ml. kg(-1). min(-1) (prolonged tamponade; P = 0.050) and increased from 2 +/- 1 to 4 +/- 2 ml. kg(-1). min(-1) in controls (P = 0.002). The change in hepatic arterial conductance (DeltaC(ha)) during acute portal vein occlusion decreased from 0.1 +/- 0.05 (baseline) to 0 +/- 0.01 ml. kg(-1). min(-1). mmHg(-1) (prolonged tamponade; P = 0.043). In controls, DeltaC(ha) did not change. Hepatic lactate extraction decreased, but hepatic release of glutathione S-transferase A did not change during cardiac tamponade. In conclusion, during low systemic perfusion, the HABR is exhausted and hepatic function is impaired without signs of cellular damage.
肝动脉缓冲反应（HABR）倾向于在肠系膜低灌注情况下维持肝脏血流。我们假设全身低灌注会损害HABR。在12头猪中，通过心包填塞使主动脉血流减少至50 ml·kg⁻¹·min⁻¹，持续1小时（短期填塞），然后再减少至30 ml·kg⁻¹·min⁻¹，持续另一小时（长期填塞）。12头未进行填塞的猪作为对照。门静脉血流从17±3（基线）降至6±4 ml·kg⁻¹·min⁻¹（长期填塞；P = 0.012），而对照组未发生变化，而肝动脉血流从2±1（基线）降至1±1 ml·kg⁻¹·min⁻¹（长期填塞；P = 0.050），对照组则从2±1增加至4±² ml·kg⁻¹·min⁻¹（P = 0.002）。急性门静脉闭塞期间肝动脉电导的变化（ΔC(ha)）从0.1±0.05（基线）降至0±0.01 ml·kg⁻¹·min⁻¹·mmHg⁻¹（长期填塞；P = 0.043）。在对照组中，ΔC(ha)未发生变化。心包填塞期间肝乳酸摄取减少，但谷胱甘肽S - 转移酶A的肝脏释放未发生变化。总之，在全身低灌注期间，HABR耗竭，肝功能受损，但无细胞损伤迹象。
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