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年轻健康志愿者急性乙醇摄入后颈动脉壁力学及压力反射敏感性研究

Mechanics of the carotid artery wall and baroreflex sensitivity after acute ethanol administration in young healthy volunteers.

作者信息

Fazio M, Bardelli M, Macaluso L, Fiammengo F, Mattei P L, Bossi M, Fabris B, Fischetti F, Pascazio L, Candido R, Carretta R

机构信息

Department of Clinical Medicine, University of Trieste, Ospedale di Cattinara, 34149 Trieste, Italy.

出版信息

Clin Sci (Lond). 2001 Sep;101(3):253-60.

Abstract

The effects of ethanol administered orally (300 mg/kg in 250 ml of water) or intravenously (7.5 mg.min(-1).kg(-1) in 250 ml of saline over 40 min) on common carotid haemodynamics, wall mechanics and baroreflex sensitivity were compared with the effects of the intravenous infusion of 250 ml of saline. Ethanol or saline was administered to 10 healthy volunteers after 30 min of supine rest, and measurements were obtained 40 min (median; range 34-46 min) after administration. After ethanol administration, the plasma alcohol level rose from 0 to 0.3+/-0.07 g/l. Mean arterial blood pressure had risen slightly at 20 min, but was normalized by 40 min, the time at which the haemodynamic study was performed. Heart rate decreased after infusion of either saline or alcohol, but was unchanged after oral ethanol administration. Both oral and intravenous ethanol administration were associated with significant decreases in baroreflex sensitivity, carotid shear stress and blood velocity, compared with resting values, while the mean carotid artery diameter was increased, and blood viscosity and mean blood flow were unchanged. No changes were observed in these parameters after saline administration. Ethanol, administered either intravenously or orally, increased the stiffness of the carotid artery and decreased the pulsatility (systo-diastolic changes) of its diameter. A direct, statistically significant correlation was found between the decrease in shear stress and the decrease in baroreflex heart rate control sensitivity after both modes of alcohol administration, while no such correlation was found between the increase in the Peterson elastic modulus and the decrease in carotid diameter pulsatility on the one hand or the decrease in baroreflex sensitivity on the other. In conclusion, reduced shear stress associated with vasodilatation of the carotid artery wall may contribute to the decrease in baroreflex sensitivity observed after acute ethanol administration.

摘要

将口服乙醇(300毫克/千克,溶于250毫升水中)或静脉注射乙醇(7.5毫克·分钟⁻¹·千克⁻¹,于40分钟内溶于250毫升生理盐水中)对颈总动脉血流动力学、血管壁力学和压力反射敏感性的影响,与静脉输注250毫升生理盐水的影响进行了比较。在10名健康志愿者仰卧休息30分钟后给予乙醇或生理盐水,并在给药后40分钟(中位数;范围34 - 46分钟)进行测量。给予乙醇后,血浆酒精水平从0升至0.3±0.07克/升。平均动脉血压在20分钟时略有升高,但在40分钟时恢复正常,此时进行血流动力学研究。输注生理盐水或乙醇后心率均下降,但口服乙醇后心率无变化。与静息值相比,口服和静脉注射乙醇均导致压力反射敏感性、颈动脉剪切应力和血流速度显著降低,而颈动脉平均直径增加,血液粘度和平均血流量未改变。给予生理盐水后这些参数无变化。静脉或口服给予乙醇均增加了颈动脉的硬度,并降低了其直径的搏动性(收缩期 - 舒张期变化)。两种给药方式后,剪切应力降低与压力反射心率控制敏感性降低之间均存在直接的、具有统计学意义的相关性,而一方面彼得森弹性模量增加与颈动脉直径搏动性降低之间,另一方面与压力反射敏感性降低之间均未发现此类相关性。总之,与颈动脉血管壁舒张相关的剪切应力降低可能导致急性乙醇给药后观察到的压力反射敏感性降低。

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