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腺苷和前列环素对麻醉猪缺氧性肺动脉高压的影响。

Influence of adenosine and prostacyclin on hypoxia-induced pulmonary hypertension in the anaesthetized pig.

作者信息

Owall A, Davilén J, Sollevi A

机构信息

Department of Cardiothoracic Anaesthetics and Intensive Care, Karolinska Hospital, Stockholm, Sweden.

出版信息

Acta Anaesthesiol Scand. 1991 May;35(4):350-4. doi: 10.1111/j.1399-6576.1991.tb03304.x.

Abstract

The effects of adenosine and prostacyclin (PGI2) infusions on hypoxia-induced pulmonary hypertension in the pulmonary and systemic circulatory systems of nine pigs were compared. The animals received the drugs in random order, and they were allowed to recover between each experimental sequence. Hypoxia was induced by reducing FiO2 to 0.12-0.13 so as to result in an arterial PO2 of approximately 6 kPa. Dose rates of adenosine or PGI2 during hypoxia were individualized in order to achieve a maximal reduction of 15% in the mean arterial blood pressure. Adenosine and PGI2 produced a fall in pulmonary vascular resistance of 36 +/- 4% (s.e.mean P less than 0.01) and 37 +/- 6% (P less than 0.01), respectively. The mean pulmonary artery pressure was reduced by 19 +/- 3% (P less than 0.01) during adenosine infusion and by 36 +/- 4% (P less than 0.01) during PGI2 infusion. The systemic haemodynamic responses to the two drugs were similar but adenosine produced a 7 +/- 2% (P less than 0.01) increase in cardiac output. Arterial PO2 during hypoxia and vasodilator treatment did not differ from the hypoxic situation without drug infusion. It is concluded that adenosine and PGI2 counteract hypoxia-induced increases in pulmonary vascular resistance similarly, but the reduction in pulmonary artery pressure was greater with PGI2 at infusion rates, causing minor systemic haemodynamic changes.

摘要

比较了腺苷和前列环素(PGI2)输注对9头猪肺循环和体循环中低氧诱导的肺动脉高压的影响。动物以随机顺序接受药物,并在每个实验序列之间使其恢复。通过将FiO2降低至0.12 - 0.13来诱导低氧,以使动脉PO2约为6 kPa。低氧期间腺苷或PGI2的剂量率个体化,以实现平均动脉血压最大降低15%。腺苷和PGI2分别使肺血管阻力下降36±4%(标准误,P<0.01)和37±6%(P<0.01)。腺苷输注期间平均肺动脉压降低19±3%(P<0.01),PGI2输注期间降低36±4%(P<0.01)。两种药物对体循环血流动力学的反应相似,但腺苷使心输出量增加7±2%(P<0.01)。低氧和血管扩张剂治疗期间的动脉PO2与未输注药物的低氧情况无差异。结论是,腺苷和PGI2类似地抵消低氧诱导的肺血管阻力增加,但在输注速率下,PGI2使肺动脉压降低幅度更大,且引起轻微的体循环血流动力学变化。

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