Ketabchi Farzaneh, Karimi Zinab, S Moosavi Seyed Mostafa
Department of Physiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Iran J Med Sci. 2014 May;39(3):275-81.
Alveolar hypoxia induces monophasic pulmonary vasoconstriction in vivo, biphasic vasoconstriction in the isolated pulmonary artery, and controversial responses in the isolated perfused lung. Pulmonary vascular responses to sustained alveolar hypoxia have not been addressed in the isolated perfused rat lung. In this study, we investigated the effect of sustained hypoxic ventilation on pulmonary artery pressure in the present of phenylephrine, an α1-receptor agonist, under the above condition.
We performed this study in the isolated perfused rat lung. After preparation, the lungs were divided randomly into five groups of normoxic-normocapnia, hypoxic-normocapnia, phenylephrine pre- or post-treated hypoxic-normocapnia and phenylephrine pre-treated normoxic-normocapnia. Pulmonary hemodynamic, airway pressure and lung weight were measured during 60 min of the experiment for each group.
In the phenylephrine-pre-treated hypoxic-normocapnia group we observed a gradual increase in pulmonary artery pressure which approximated the results seen in the phenylephrine-pre-treated normoxic-normocapnia group. In contrast, in the phenylephrine-post-treated hypoxic-normcapnic group, pulmonary artery pressure did not change during the first 3 min of hypoxic-normocapnia. However at 1.5 min after administration of phenylephrine, this pressure began to increase sharply and continued until the end of the experiment. This response was biphasic (0-10 min: acute phase, 10-60 min: sustained phase) with significantly higher pulmonary artery pressure compared to the other groups.
This study, for the first time, showed biphasic hypoxic pulmonary vasoconstriction in the isolated perfused rat lung with the sole administration of phenylephrine after but not before hypoxic gas ventilation. This finding suggested a facilitative role of alveolar hypoxia on pulmonary vasoconstriction induced by an α1-receptor agonist.
肺泡低氧在体内可诱导单相肺血管收缩,在离体肺动脉中可诱导双相血管收缩,而在离体灌注肺中其反应存在争议。在离体灌注大鼠肺中,尚未研究肺血管对持续性肺泡低氧的反应。在本研究中,我们在上述条件下,研究了在α1受体激动剂去氧肾上腺素存在的情况下,持续性低氧通气对肺动脉压力的影响。
我们在离体灌注大鼠肺中进行了本研究。制备完成后,将肺随机分为常氧-正常碳酸血症、低氧-正常碳酸血症、去氧肾上腺素预处理或后处理的低氧-正常碳酸血症以及去氧肾上腺素预处理的常氧-正常碳酸血症五组。在每组实验的60分钟内测量肺血流动力学、气道压力和肺重量。
在去氧肾上腺素预处理的低氧-正常碳酸血症组中,我们观察到肺动脉压力逐渐升高,这与去氧肾上腺素预处理的常氧-正常碳酸血症组的结果相近。相比之下,在去氧肾上腺素后处理的低氧-正常碳酸血症组中,在低氧-正常碳酸血症的最初3分钟内肺动脉压力没有变化。然而,在给予去氧肾上腺素1.5分钟后,该压力开始急剧上升并持续至实验结束。这种反应是双相的(0 - 10分钟:急性期,10 - 60分钟:持续期),与其他组相比,肺动脉压力显著更高。
本研究首次表明,在离体灌注大鼠肺中,仅在低氧气体通气后而非之前给予去氧肾上腺素时,会出现双相低氧性肺血管收缩。这一发现提示肺泡低氧对α1受体激动剂诱导的肺血管收缩具有促进作用。