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促甲状腺激素释放激素在实验性失血性休克中的作用——心血管机制

Action of thyrotropin-releasing hormone in experimental hemorrhagic shock--cardiovascular mechanism.

作者信息

Zheng D, Chen H S, Hu D Y

机构信息

Trauma Research Center, 43rd Hospital, Kunming, Yunnan.

出版信息

J Tongji Med Univ. 1990;10(3):187-92. doi: 10.1007/BF02986460.

Abstract

Thyrotropin-releasing hormone (TRH) could improve mean arterial pressure (MAP), myocardial contractile parameters (+/- dp/dtmax, Vpm and Vmax) and increase plasma epinephrine level significantly at 10 min after TRH administration in hemorrhagic shock rabbits, but the action of TRH on MAP and the myocardial contractility did not appear in rabbits pre-treated with reserpine (4 mg/kg, 24 h pre-treatment, i.v.). TRH had no effects on myocardial contractility and MAP at 20 and 30 min after administration to rabbits pre-treated with beta-adrenergic blocker propranolol (1 mg/kg, 1 h before TRH injection i.v.), but it did exert effects on these parameters in rabbits pre-treated with alpha-adrenergic blocker phenoxybenzamine. Experiments in vitro showed that, although TRH (10(-4) M/L) had no direct effect on heart, left atrium and aortic strip, it did potentiate the inotropic effects of isoprenaline and dopamine on the left atrium. These results suggested that antishock effect of TRH is related to adrenergic system. TRH stimulates sympathomedullary system to secrete epinephrine and sensitize the beta-receptors, but not alpha-receptors. Thus, TRH improves cardiac contractility, cardiac output and hemodynamics during hemorrhagic shock. The sensitization of the beta- and dopamine receptors played an important role in producing direct peripheral actions of TRH.

摘要

促甲状腺激素释放激素(TRH)可使失血性休克兔在给予TRH后10分钟时平均动脉压(MAP)、心肌收缩参数(±dp/dtmax、Vpm和Vmax)显著改善,并使血浆肾上腺素水平升高,但在经利血平(4mg/kg,静脉注射,预处理24小时)预处理的兔中,TRH对MAP和心肌收缩性的作用未出现。在给予β-肾上腺素能阻滞剂普萘洛尔(1mg/kg,在静脉注射TRH前1小时)预处理的兔中,TRH在给药后20和30分钟时对心肌收缩性和MAP无影响,但在给予α-肾上腺素能阻滞剂酚苄明预处理的兔中,TRH对这些参数有作用。体外实验表明,虽然TRH(10⁻⁴M/L)对心脏、左心房和主动脉条无直接作用,但它确实增强了异丙肾上腺素和多巴胺对左心房的正性肌力作用。这些结果提示TRH的抗休克作用与肾上腺素能系统有关。TRH刺激交感髓质系统分泌肾上腺素并使β受体敏感,但不使α受体敏感。因此,TRH在失血性休克期间改善心脏收缩性、心输出量和血流动力学。β受体和多巴胺受体的敏感化在产生TRH的直接外周作用中起重要作用。

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