Sardella G L, Bech F R, Cronenwett J L
Section of Vascular Surgery, Dartmouth-Hitchcock Medical Center, Hanover, New Hampshire 03756.
J Surg Res. 1990 Oct;49(4):354-60. doi: 10.1016/0022-4804(90)90037-3.
We have previously shown that iv glucagon improved survival in rats from 33 to 83% when given after, but not during, superior mesenteric artery (SMA) occlusion. This study investigated potential hemodynamic mechanisms of this effect. In Part 1, cardiac output (CO) was measured in 12 male Sprague-Dawley rats with an electromagnetic flow-probe that had been placed around the ascending aorta 5 days previously. Under pentobarbital anesthesia, the SMA was occluded for 85 min. All rats received normal saline (NS, 15 ml/kg/hr) for 1 hr before and after SMA declamping. Control rats (n = 6) received only NS. Treated rats (n = 6) received NS plus glucagon (1.6 micrograms/kg/min iv) for 1 hr postocclusion. CO decreased 50% during the first hour after SMA declamping in control rats, but only 11% in glucagon-treated rats (P less than 0.02). Systemic vascular resistance (SVR) increased by 90% in control rats by 1 hr after declamp, but only 9% in glucagon rats (P less than 0.04). Systemic blood pressure and heart rate were not different in the two groups. In Part 2, relative distribution of visceral blood flow was measured with radiolabeled microspheres injected in the aortic root before clamping, before declamping, and 1 hr postdeclamping in 10 rats (5 glucagon, 5 control) using the above protocol. After SMA clamping, the proportion of visceral blood flow distributed to the intestine fell from 45 to 20% (P less than 0.05). During reperfusion, the proportion of intestinal flow exceeded baseline (P less than 0.05), but was not different in control (64%) and glucagon-treated rats (56%).(ABSTRACT TRUNCATED AT 250 WORDS)
我们之前已经表明,肠系膜上动脉(SMA)闭塞后而非闭塞期间静脉注射胰高血糖素可使大鼠存活率从33%提高到83%。本研究探讨了这种效应潜在的血流动力学机制。在第1部分中,用电磁血流探头测量了12只雄性Sprague-Dawley大鼠的心输出量(CO),该探头已于5天前置于升主动脉周围。在戊巴比妥麻醉下,SMA闭塞85分钟。所有大鼠在SMA夹闭解除前后各1小时接受生理盐水(NS,15 ml/kg/小时)。对照大鼠(n = 6)仅接受NS。处理组大鼠(n = 6)在闭塞后1小时接受NS加胰高血糖素(1.6微克/千克/分钟静脉注射)。在对照大鼠中,SMA夹闭解除后的第1小时内CO下降了50%,但在胰高血糖素处理组大鼠中仅下降了11%(P < 0.02)。夹闭解除后1小时,对照大鼠的全身血管阻力(SVR)增加了90%,但在胰高血糖素处理组大鼠中仅增加了9%(P < 0.04)。两组的全身血压和心率无差异。在第2部分中,使用上述方案,在夹闭前、夹闭解除前以及夹闭解除后1小时,向10只大鼠(5只胰高血糖素处理组,5只对照组)的主动脉根部注射放射性微球,测量内脏血流的相对分布。SMA夹闭后,分配到肠道的内脏血流比例从45%降至20%(P < 0.05)。在再灌注期间,肠道血流比例超过基线(P < 0.05),但对照组(64%)和胰高血糖素处理组大鼠(56%)之间无差异。(摘要截断于250字)