Tsai Amy G, Johnson Paul C, Intaglietta Marcos
Department of Bioengineering, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093-0412, USA.
Physiol Rev. 2003 Jul;83(3):933-63. doi: 10.1152/physrev.00034.2002.
As arterialized blood transits from the central circulation to the periphery, oxygen exits through the vessel walls driven by radial oxygen gradients that extend from the red blood cell column, through the plasma, the vessel wall, and the parenchymal tissue. This exit determines a longitudinal gradient of blood oxygen saturation whose extent is inversely related to the level of metabolic activity of the tissue, being small for the brain and considerable for skeletal muscle at rest where hemoglobin is only half-saturated with oxygen when blood arrives to the capillaries. Data obtained by a variety of methods show that the oxygen loss is too great to be explained by diffusion alone, and oxygen gradients measured in the arteriolar wall provide evidence that this structure in vivo is a very large oxygen sink, and suggests a rate of oxygen consumption two orders of magnitude greater than seen in in vitro studies. Longitudinal gradients in the capillary network and radial gradients in surrounding tissue also show a dependence on the metabolic rate of the tissue, being more pronounced in brain than in resting skeletal muscle and mesentery. Mean PO2 values increase from the postcapillary venules to the distal vessels of this network while radial gradients indicate additional oxygen loss. This circumstance may be due to pathways with higher flow having higher oxygen content than low flow pathways as well as possible oxygen uptake from adjacent arterioles. Taken together, these newer findings on oxygen gradients in the microcirculation require a reexamination of existing concepts of oxygen delivery to tissue and the role of the capillaries in this process.
当动脉化血液从体循环流向周边时,氧气在径向氧梯度的驱动下通过血管壁逸出,该梯度从红细胞柱延伸,穿过血浆、血管壁和实质组织。这种逸出决定了血氧饱和度的纵向梯度,其程度与组织的代谢活动水平呈负相关,对于大脑来说较小,而对于静息状态下的骨骼肌来说则相当可观,在那里当血液到达毛细血管时血红蛋白的氧饱和度仅为一半。通过多种方法获得的数据表明,氧气损失过大,无法仅用扩散来解释,并且在小动脉壁中测量到的氧梯度提供了证据,表明这种结构在体内是一个非常大的氧汇,并表明其耗氧率比体外研究中观察到的高两个数量级。毛细血管网络中的纵向梯度和周围组织中的径向梯度也显示出对组织代谢率的依赖性,在大脑中比在静息骨骼肌和肠系膜中更明显。平均PO2值从毛细血管后微静脉到该网络的远端血管增加,而径向梯度表明存在额外的氧气损失。这种情况可能是由于高流量路径比低流量路径具有更高的氧含量,以及可能从相邻小动脉摄取氧气。综上所述,这些关于微循环中氧梯度的最新发现需要重新审视现有的组织氧输送概念以及毛细血管在此过程中的作用。