氨茶碱对慢性阻塞性肺疾病患者脑组织氧合的影响。

Effect of aminophylline on brain tissue oxygenation in patients with chronic obstructive lung disease.

作者信息

Nishimura M, Suzuki A, Yoshioka A, Yamamoto M, Akiyama Y, Miyamoto K, Kishi F, Kawakami Y

机构信息

First Department of Medicine, School of Medicine, Hokkaido University, Sapporo, Japan.

出版信息

Thorax. 1992 Dec;47(12):1025-9. doi: 10.1136/thx.47.12.1025.

DOI:10.1136/thx.47.12.1025

PMID:1494765

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1021094/

Abstract

BACKGROUND

It is known that theophylline reduces cerebral blood flow in humans. To quantitatively assess the possible adverse effect of theophylline on brain tissue oxygen tension (PO2) due to decreased cerebral blood flow, two sets of experiments were conducted in mildly hypoxaemic patients with chronic obstructive lung disease.

METHODS

Firstly, internal jugular venous PO2 (PjO2) was measured simultaneously with arterial and mixed venous blood PO2 (PaO2 and PvO2) during right heart catheterisation in 10 subjects (mean PaO2 73 mm Hg; conversion factor: 10 mm Hg = 1.33 kPa)) before and after intravenous infusion of aminophylline (6 mg/kg). The PjO2 and PvO2 were considered to reflect the average tissue PO2 for the brain and for the whole body respectively. Secondly, the relation between PaO2 and PjO2 over a wide range, with the PaCO2 similar to that in the first study, was investigated in a different group of 12 subjects by stepwise changes in inspiratory gas composition.

RESULTS

The mean PjO2 decreased by as much as 6 mm Hg 15 minutes after an infusion of aminophylline, whereas PaO2 stayed at the same level and PvO2 showed only a small decrease. The low PjO2 value of 29 (SD 6) mm Hg with aminophylline in the first study was similar to the PjO2 value of 30 (2) mm Hg obtained during severe hypoxia (PaO2 45 mm Hg) in the second study. The coefficient of oxygen delivery for the brain decreased by 29% with aminophylline treatment, but did not change significantly during severe hypoxic challenge.

CONCLUSIONS

These data suggest that an infusion of aminophylline lowers brain tissue PO2 appreciably when given to mildly hypoxaemic patients with chronic obstructive lung disease.

摘要

背景

已知氨茶碱可降低人体脑血流量。为了定量评估由于脑血流量减少，氨茶碱对脑组织氧分压（PO2）可能产生的不良影响，我们对患有慢性阻塞性肺疾病的轻度低氧血症患者进行了两组实验。

方法

首先，在10名受试者（平均动脉血氧分压73 mmHg；换算系数：10 mmHg = 1.33 kPa）右心导管插入术期间，在静脉输注氨茶碱（6 mg/kg）前后，同时测量颈内静脉血氧分压（PjO2）以及动脉血氧分压和混合静脉血氧分压（PaO2和PvO2）。PjO2和PvO2分别被认为反映大脑和全身的平均组织PO2。其次，在另一组12名受试者中，通过逐步改变吸入气体成分，研究在与第一项研究相似的动脉血二氧化碳分压（PaCO2）条件下，PaO2和PjO2在较宽范围内的关系。

结果

输注氨茶碱15分钟后，平均PjO2下降多达6 mmHg，而PaO2保持在同一水平，PvO2仅略有下降。在第一项研究中，使用氨茶碱时PjO2的低值为29（标准差6）mmHg，与第二项研究中严重缺氧（PaO2 45 mmHg）时获得的PjO2值30（2）mmHg相似。氨茶碱治疗使大脑的氧输送系数降低了29%，但在严重缺氧挑战期间没有显著变化。