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酸中毒对福司林和肾上腺素正性肌力作用的影响:一项剂量反应研究。

Influence of acidosis on cardiotonic effects of colforsin and epinephrine: a dose-response study.

机构信息

Department of Anesthesiology, University of Tsukuba, Tsukuba City, Japan.

出版信息

J Cardiothorac Vasc Anesth. 2013 Oct;27(5):925-32. doi: 10.1053/j.jvca.2012.09.019. Epub 2012 Dec 23.

DOI:10.1053/j.jvca.2012.09.019
PMID:23266286
Abstract

OBJECTIVE

Acidosis produces a negative inotropic effect on cardiac muscle against which catecholamines and phosphodiesterase III inhibitors have limited therapeutic effects. This study evaluated the effects of colforsin, which directly activates adenylate cyclase without β-adrenergic receptor activation, in isolated Langendorff rat hearts in a pH- and concentration-dependent manner.

DESIGN

Experimental animal study.

SETTING

A university laboratory.

PARTICIPANTS

Sprague-Dawley rats.

INTERVENTIONS

Hearts were isolated and perfused with 4-(2-hydroxyethyl)-1-piperazineethanesulfonic acid/Tyrode solution (pH 7.4) in the Langendorff preparation. The hearts were assigned randomly to the control (pH 7.4), mild acidosis (pH 7.0), or severe acidosis (pH 6.6) group (n = 8 per group) and were perfused continuously with colforsin 10(-7), 10(-6), and 10(-5) mol/L.

MEASUREMENTS AND MAIN RESULTS

Maximum dP/dt was determined, and the concentration-response relation was evaluated at each pH. Colforsin at 10(-6) mol/L increased the maximum dP/dt from 2,592 ± 557 to 5,189 ± 721 mmHg/s (p < 0.001) and from 1,942 ± 325 to 3,399 ± 608 mmHg/s (p < 0.001) in the control and mild acidosis groups, respectively; whereas colforsin, 10(-5) mol/L, significantly increased the maximum dP/dt even in the severe acidosis group. No significant difference was seen in maximum dP/dt among the 3 groups after infusion with colforsin 10(-5) mol/L.

CONCLUSIONS

In contrast to catecholamines and other inodilators, colforsin at a high concentration restores decreased cardiac contractility against severe acidosis to an extent similar to physiologic pH.

摘要

目的

酸中毒对心肌产生负性肌力作用,而儿茶酚胺和磷酸二酯酶 III 抑制剂对此的治疗效果有限。本研究以 pH 值和浓度依赖的方式评估了直接激活腺苷酸环化酶而不激活β肾上腺素能受体的福司柯林在 pH 值和浓度依赖的方式在 Langendorff 分离的大鼠心脏中的作用。

设计

实验动物研究。

设置

大学实验室。

参与者

Sprague-Dawley 大鼠。

干预

心脏用 4-(2-羟乙基)-1-哌嗪乙磺酸/Tyrode 溶液(pH7.4)在 Langendorff 制剂中分离并灌注。心脏随机分为对照组(pH7.4)、轻度酸中毒组(pH7.0)和重度酸中毒组(pH6.6)(每组 8 只),并连续灌注福司柯林 10(-7)、10(-6)和 10(-5)mol/L。

测量和主要结果

测定最大 dp/dt,并在每个 pH 值下评估浓度反应关系。福司柯林 10(-6)mol/L 使对照组和轻度酸中毒组的最大 dp/dt 从 2592 ± 557 增加到 5189 ± 721 mmHg/s(p < 0.001)和从 1942 ± 325 增加到 3399 ± 608 mmHg/s(p < 0.001);而福司柯林 10(-5)mol/L 甚至在重度酸中毒组中也显著增加了最大 dp/dt。在输注福司柯林 10(-5)mol/L 后,三组之间的最大 dp/dt 无显著差异。

结论

与儿茶酚胺和其他正性肌力药不同,福司柯林在高浓度下可使重度酸中毒引起的心肌收缩力下降恢复到接近生理 pH 值的程度。

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