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[低碳酸血症/碱中毒对离体灌注兔肺液体滤过率的影响]

[Effect of hypocapnia/alkalosis on the fluid filtration rate in isolated and perfused rabbit lungs].

作者信息

Urich Daniela, Trejo Humberto, Pezzulo Alejandro, Caraballo Juan Carlos, Gutiérrez Jeydith, Castro Ignacio, Sánchez-de León Roberto

机构信息

Sección de Fisiología Respiratoria, Facultad de Medicina, Escuela de Medicina Luis Razetti, Universidad Central de Venezuela, Caracas, Venezuela.

出版信息

Invest Clin. 2008 Jun;49(2):181-93.

Abstract

Hypocapnia/alkalosis is a consequence of several lung and metabolic pathologies. The aim of this study was to determine whether the increase of fluid filtration rate (FFR) that occurs during Hypocapnia/alkalosis circumstances is determined by hypocapnia, alkalosis or both. 7 groups were formed (N=36) using isolated rabbit lungs. Group 1: Control (PCO2 6%, pH: 7.35-7.45); Group 2 (n=6): Hypocapnia/Alkalosis (CO2 1%, pH: 7.9); Group 3 (n=6): Hypocapnia/Normo-pH (CO2 1% pH 7.35-7.45), Group 4 (n=6) Normocapnia/Alcalosis (CO2 6%, pH: 7.9). Fenoterol, papaverine and hydrocortisone were added to Groups 5, 6 and 7 (n=4) respectively, all under Normocapnia/Alkalosis. FFR and Pulmonary Arterial Pressure (Pap) were considerably higher in group 2 than in control (FFR: 1.92g/min +/- 0.6 vs 0.0 g/min +/- 0.006). A strong influence exerted by pH was observed when Group 3 and group 4 were compared (FFR: 0.02 g/min +/- 0.009 vs 2.3 g/min +/- 0.9) and (Pap: 13.5 cmH2O +/- 1.4 vs 90 cmH2O +/- 15). A reduced effect was observed in groups 5 and 6 (papaverine and hydrocorisone) and a totally abolished effect was observed in group 7 (fenoterol) (FFR: 0.001 +/- 0.0003 mL/min and Pap: 14 +/- 0.8 cmH2O). Pulmonary edema induced by Hypocapnia/alkalosis is a consequence of alkalosis and not of hypocapnia. This effect could be due to inflammatory damage in the lung parenchyma and alkalosis-mediated vasoconstriction.

摘要

低碳酸血症/碱中毒是多种肺部和代谢性疾病的结果。本研究的目的是确定在低碳酸血症/碱中毒情况下发生的液体滤过率(FFR)增加是由低碳酸血症、碱中毒还是两者共同决定的。使用离体兔肺组建了7组(N = 36)。第1组:对照组(二氧化碳分压6%,pH:7.35 - 7.45);第2组(n = 6):低碳酸血症/碱中毒组(二氧化碳1%,pH:7.9);第3组(n = 6):低碳酸血症/正常pH组(二氧化碳1%,pH 7.35 - 7.45),第4组(n = 6):正常碳酸血症/碱中毒组(二氧化碳6%,pH:7.9)。分别向第5、6和7组(n = 4)添加了非诺特罗、罂粟碱和氢化可的松,均处于正常碳酸血症/碱中毒状态。第2组的FFR和肺动脉压(Pap)显著高于对照组(FFR:1.92g/分钟±0.6 vs 0.0g/分钟±0.006)。比较第3组和第4组时观察到pH有强烈影响(FFR:0.02g/分钟±0.009 vs 2.3g/分钟±0.9)以及(Pap:13.5cmH₂O±1.4 vs 90cmH₂O±15)。在第5组和第6组(罂粟碱和氢化可的松)观察到效应减弱,在第7组(非诺特罗)观察到效应完全消除(FFR:0.001±0.0003mL/分钟和Pap:14±0.8cmH₂O)。低碳酸血症/碱中毒诱导的肺水肿是碱中毒的结果而非低碳酸血症的结果。这种效应可能是由于肺实质的炎症损伤和碱中毒介导的血管收缩。

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