Otsuka A, Ogihara T, Kohara K, Mikami H, Katahira K, Tsunetoshi T, Kumahara Y
Department of Medicine and Geriatrics, Osaka University Medical School, Japan.
Hypertension. 1988 Jul;12(1):59-66. doi: 10.1161/01.hyp.12.1.59.
In a search for factors contributing to the sustained blood pressure (BP) elevation in acutely volume-loaded animals, dextran dissolved in lactated Ringer's solution (20 ml/kg) was infused into 34 mongrel dogs over a period of 1 hour under pentobarbital anesthesia and changes in hemodynamic and humoral variables were monitored during its infusion and for 3 hours after its infusion. BP elevation during volume loading (from 114 +/- 3 to 128 +/- 3 [SEM] mm Hg) was attributed to an increase in cardiac output. After volume loading, some dogs maintained BP elevation whereas others did not. The former group showed an increase in total peripheral resistance, demonstrating a transformation of cardiac output to total peripheral resistance as a responsible factor in maintenance of the elevated BP. The plasma levels of norepinephrine, vasopressin, and plasma renin activity were not elevated, indicating that these vasoactive factors were not responsible for elevation of the BP or total peripheral resistance. The changes in the hematocrit, atrial natriuretic factor, urine volume, and urinary sodium excretion were identical in the two groups, and natriuresis was not prominent when total peripheral resistance was high. Pressor responses to norepinephrine and angiotensin II were potentiated 3 hours after stopping infusion in both groups, but this potentiation was not correlated with the increase in total peripheral resistance or mean BP. Thus, acute volume expansion produced resistance-dependent hypertension following the initial volume-dependent hypertension. It is unlikely that a vascular sensitizing natriuretic factor plays a role in the resistance-dependent BP elevation. The mechanism and physiological importance of hypersensitivity to vasoactive substances remain to be elucidated.
为了寻找导致急性容量负荷动物血压持续升高的因素,在戊巴比妥麻醉下,于1小时内将溶解于乳酸林格液(20ml/kg)中的右旋糖酐注入34只杂种犬体内,并在输注期间及其输注后3小时监测血流动力学和体液变量的变化。容量负荷期间血压升高(从114±3升至128±3[SEM]mmHg)归因于心输出量增加。容量负荷后,一些犬的血压持续升高,而另一些则没有。前一组显示总外周阻力增加,表明心输出量向总外周阻力的转变是维持血压升高的一个重要因素。去甲肾上腺素、血管加压素和血浆肾素活性的血浆水平未升高,表明这些血管活性因子与血压或总外周阻力的升高无关。两组的血细胞比容、心房利钠因子、尿量和尿钠排泄变化相同,当总外周阻力较高时,利钠作用不明显。两组在停止输注3小时后对去甲肾上腺素和血管紧张素II的升压反应均增强,但这种增强与总外周阻力或平均血压的升高无关。因此,急性容量扩张在最初的容量依赖性高血压之后产生了阻力依赖性高血压。血管致敏性利钠因子不太可能在阻力依赖性血压升高中起作用。对血管活性物质超敏反应的机制和生理重要性仍有待阐明。