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[根据冠状动脉狭窄严重程度,氟烷对局部氧供需关系影响的差异]

[Difference in the effect of halothane on regional oxygen demand-supply relationship depending on the severity of coronary artery stenosis].

作者信息

Toriumi S, Sakata S

机构信息

Department of Surgical Center, University Hospital of Tokushima.

出版信息

Masui. 1990 Apr;39(4):430-6.

PMID:2362338
Abstract

We examined the effect of halothane on myocardial oxygen balance and hemodynamics in three groups of canine heart. We measured regional subendocardial oxygen tension before and after 30 minute inhalation of 0.8% and 1.5% halothane in the mixture of nitrogen and oxygen (FIO2 not equal to 0.5). In moderate and severe stenosis group, left circumflex coronary artery flow was reduced to 66% and 31% respectively, at buprenorphine-anesthetized basal condition. In occlusion group, left circumflex coronary artery was ligated at its origin. Both concentrations of halothane decreased heart rate, aortic pressure and LV dp/dt max in all groups. Subendocardial oxygen tension increased in moderate stenosis group. But it was unchanged in severe stenosis group, and it rather decreased in occlusion group with 1.5% halothane inhalation. Halothane might improve endocardial oxygen demand-supply relation in the myocardium with mild to moderate coronary stenosis, while it will possibly deteriorate endocardial oxygen demand-supply balance in ischemic myocardium after coronary artery occlusion.

摘要

我们研究了氟烷对三组犬心的心肌氧平衡和血流动力学的影响。我们在氮气和氧气混合物(FIO2不等于0.5)中吸入0.8%和1.5%氟烷30分钟前后,测量了局部心内膜下氧张力。在中度和重度狭窄组中,左旋冠状动脉血流量在丁丙诺啡麻醉的基础状态下分别降至66%和31%。在闭塞组中,左旋冠状动脉在其起始处结扎。两种浓度的氟烷均降低了所有组的心率、主动脉压和左心室dp/dt max。中度狭窄组的心内膜下氧张力升高。但重度狭窄组无变化,而在闭塞组吸入1.5%氟烷时反而降低。氟烷可能改善轻度至中度冠状动脉狭窄心肌的心内膜氧供需关系,而在冠状动脉闭塞后可能使缺血心肌的心内膜氧供需平衡恶化。

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