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人体输注腺苷后的血流动力学和代谢效应。

Haemodynamic and metabolic effects of infused adenosine in man.

作者信息

Edlund A, Sollevi A, Linde B

机构信息

Department of Clinical Physiology, Huddinge and Karolinska Hospital, Sweden.

出版信息

Clin Sci (Lond). 1990 Aug;79(2):131-8. doi: 10.1042/cs0790131.

Abstract
  1. Haemodynamic and metabolic effects of intravenous infusion of adenosine, an endogenous vasodilator, were studied in healthy humans. 2. Catheters were inserted into pulmonary and brachial arteries and into the hepatic and subclavian veins. Cardiac output was determined according to the Fick principle, and splanchnic blood flow was measured by using extraction of Indocyanine Green. Skin blood flow was estimated by a laser Doppler technique, calf blood flow by venous occlusion plethysmography and skeletal muscle and adipose tissue blood flow by a local isotope clearance technique. 3. Adenosine (infused in steps from 40 to 80 micrograms min-1 kg-1 into a central vein) elicited a gradual reduction in the peripheral vascular resistance to less than 50% of the basal level. There was a slight increase in the systemic blood pressure, but the pulmonary arterial and the ventricular filling pressures were unchanged. Cardiac output was doubled, accomplished by a combination of a positive chronotropic effect and an increase in stroke volume, which may be secondary to diminished peripheral resistance. 4. Skin blood flow increased by 100% at 50 micrograms of adenosine min-1 kg-1, whereas splanchnic blood flow rose significantly at 60 micrograms of adenosine min-1 kg-1. Blood flow in the calf, gastrocnemius muscle and adipose tissue did not change significantly. 5. Arterial concentrations of noradrenaline and adrenaline increased by 62 and 43%, respectively, during infusion of adenosine. Arterial levels of glycerol were depressed by more than 50%, but those of glucose and pyruvate were unchanged. 6. In conclusion, exogenous adenosine caused a marked systemic vasodilatation, with different responsiveness in the investigated vascular beds.(ABSTRACT TRUNCATED AT 250 WORDS)
摘要
  1. 我们对健康人体静脉输注内源性血管舒张剂腺苷后的血流动力学和代谢效应进行了研究。2. 将导管插入肺动脉、肱动脉、肝静脉和锁骨下静脉。根据菲克原理测定心输出量,采用吲哚菁绿提取法测量内脏血流量。通过激光多普勒技术估算皮肤血流量,通过静脉阻断体积描记法测量小腿血流量,通过局部同位素清除技术测量骨骼肌和脂肪组织血流量。3. 腺苷(从40至80微克·分钟⁻¹·千克⁻¹逐步输注至中心静脉)使外周血管阻力逐渐降低至基础水平的50%以下。全身血压略有升高,但肺动脉压和心室充盈压未变。心输出量增加一倍,这是由正性变时作用和每搏输出量增加共同实现的,后者可能继发于外周阻力降低。4. 腺苷剂量为50微克·分钟⁻¹·千克⁻¹时,皮肤血流量增加100%,而腺苷剂量为60微克·分钟⁻¹·千克⁻¹时,内脏血流量显著增加。小腿、腓肠肌和脂肪组织的血流量无明显变化。5. 输注腺苷期间,去甲肾上腺素和肾上腺素的动脉浓度分别升高62%和43%。甘油的动脉水平降低超过50%,但葡萄糖和丙酮酸的水平未变。6. 总之,外源性腺苷引起明显的全身血管舒张,在所研究的血管床中具有不同的反应性。(摘要截短至250字)

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