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出血和复苏后ATP-MgCl2对门静脉和肝动脉血流的不同影响。

Differential effects of ATP-MgCl2 on portal and hepatic arterial blood flow after hemorrhage and resuscitation.

作者信息

Wang P, Ba Z F, Chaudry I H

机构信息

Department of Surgery, Michigan State University, East Lansing 48824.

出版信息

Am J Physiol. 1992 Dec;263(6 Pt 1):G895-900. doi: 10.1152/ajpgi.1992.263.6.G895.

Abstract

Although ATP-MgCl2 administration after hemorrhage and resuscitation restores the decreased hepatic blood flow, it is not known whether this is due to the increase in portal blood flow or hepatic arterial blood flow. To study this, rats underwent a midline laparotomy (i.e., trauma induced) and were bled to and maintained at a mean arterial pressure of 40 mmHg until 40% of maximal shed blood volume was returned in the form of Ringer lactate (RL). The animals were resuscitated with four times the volume of the shed blood with RL, during and after which ATP-MgCl2 (50 mumol/kg body wt) or an equal volume of normal saline was infused intravenously over 95 min. Cardiac output and organ blood flow were determined by 85Sr-labeled microspheres at 90 min after the completion of resuscitation. The results indicate that portal blood flow and total hepatic blood flow decreased significantly after hemorrhage and resuscitation. ATP-MgCl2 treatment, however, restored these parameters to sham values. In contrast, hepatic arterial blood flow did not change significantly after either hemorrhage and resuscitation or ATP-MgCl2 infusion. Moreover, the depressed cardiac output was normalized and coronary blood flow was higher than shams after ATP-MgCl2 treatment. Unlike small intestinal blood flow, blood flows to the stomach, spleen, pancreas, mesentery, and cecum were not markedly affected with ATP-MgCl2 infusion. Thus the restoration of hepatic blood flow with ATP-MgCl2 treatment under such conditions is due to the increased portal blood flow, i.e., solely due to the increased small intestinal blood flow.

摘要

尽管出血和复苏后给予ATP-MgCl₂可恢复降低的肝血流量,但尚不清楚这是由于门静脉血流量增加还是肝动脉血流量增加所致。为了研究这一问题,对大鼠进行中线剖腹手术(即诱发创伤),放血至平均动脉压为40 mmHg并维持该水平,直到以乳酸林格液(RL)的形式回输40%的最大失血量。用4倍失血量的RL对动物进行复苏,在此期间及之后,在95分钟内静脉输注ATP-MgCl₂(50 μmol/kg体重)或等体积的生理盐水。复苏完成后90分钟,用⁸⁵Sr标记的微球测定心输出量和器官血流量。结果表明,出血和复苏后门静脉血流量和肝总血流量显著降低。然而,ATP-MgCl₂治疗可将这些参数恢复至假手术组水平。相比之下,出血和复苏后或输注ATP-MgCl₂后肝动脉血流量均无显著变化。此外,ATP-MgCl₂治疗后,降低的心输出量恢复正常,冠状动脉血流量高于假手术组。与小肠血流量不同,ATP-MgCl₂输注对胃、脾、胰腺、肠系膜和盲肠的血流量没有明显影响。因此,在这种情况下,ATP-MgCl₂治疗使肝血流量恢复是由于门静脉血流量增加,即仅由于小肠血流量增加。

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