Tod M L, Yoshimura K, Rubin L J
Department of Medicine, University of Maryland School of Medicine, Baltimore 21201.
J Appl Physiol (1985). 1991 Mar;70(3):1315-22. doi: 10.1152/jappl.1991.70.3.1315.
The pulmonary circulation in the adult is characterized by being relatively distensible, but whether the newborn lung shares this feature is less certain. We perfused isolated lungs treated with indomethacin from lambs of four ages (less than 1, 2-4, 12-14, and 30-32 days) to determine the effects of increasing left atrial pressure on the pulmonary vascular pressures measured by vascular inflow and outflow occlusion. An index of pulmonary vascular distensibility was assessed by comparing the slope of the pulmonary vascular pressure at the upstream end of a region as a function of the pressure at the downstream end of the region. A vascular distensibility index (VDI) of 1 indicates a rigid nondistensible system, whereas a VDI less than 1 indicates some degree of distensibility. During normoxia, lungs from all age groups were relatively indistensible as determined by VDI for the total vasculature (VDItotal) as well as for the different regions based on occlusion pressures (VDIarterial, VDImiddle, and VDIvenous). There were significant effects of age on the VDItotal, with decreases in the normoxic values occurring over the first 12-14 days of age, indicating an increase in pulmonary vascular distensibility. Only the VDIvenous was similarly affected by increasing neonatal age. Hypoxia significantly reduced the VDItotal in these same age groups. In addition, hypoxia, which increased the pressure gradients of the arterial and middle regions, significantly increased the VDIarterial in the youngest and oldest age groups but significantly decreased the VDImiddle at all ages by approximately 50%. In summary, we observed age-related changes in the vascular distensibility of the pulmonary circulation, with the VDItotal decreasing with increasing postnatal age.(ABSTRACT TRUNCATED AT 250 WORDS)
成年动物的肺循环特点是具有相对较大的可扩张性,但新生儿的肺是否具有这一特征尚不确定。我们对来自四个年龄段(小于1天、2 - 4天、12 - 14天和30 - 32天)羔羊的经吲哚美辛处理的离体肺进行灌注,以确定增加左心房压力对通过血管流入和流出阻塞测量的肺血管压力的影响。通过比较一个区域上游端的肺血管压力斜率与该区域下游端压力的函数关系来评估肺血管可扩张性指数。血管可扩张性指数(VDI)为1表示刚性不可扩张系统,而VDI小于1表示有一定程度的可扩张性。在常氧条件下,根据总血管系统的VDI(VDItotal)以及基于阻塞压力的不同区域(VDI动脉、VDI中间、VDI静脉)确定,所有年龄组的肺相对不可扩张。年龄对VDItotal有显著影响,在出生后的前12 - 14天常氧值降低,表明肺血管可扩张性增加。只有VDI静脉受到新生儿年龄增加的类似影响。低氧显著降低了这些相同年龄组的VDItotal。此外,增加动脉和中间区域压力梯度的低氧,在最年幼和最年长的年龄组中显著增加了VDI动脉,但在所有年龄组中显著降低了VDI中间约50%。总之,我们观察到肺循环血管可扩张性存在与年龄相关的变化,VDItotal随出生后年龄增加而降低。(摘要截断于250字)