Mózes T, Wieszt E, Zahajszky T
Department of Surgery III, Semmelweis University Medical School, Budapest, Hungary.
J Surg Res. 1989 Dec;47(6):476-81. doi: 10.1016/0022-4804(89)90123-6.
The role of PGF2 alpha in circulatory shock of intestinal origin was investigated in anesthetized dogs by measuring PGF2 alpha levels in superior mesenteric vein, right ventricle, aorta, and femoral vein during superior mesenteric artery occlusion-induced shock by comparing the circulatory effects of exogenous PGF2 alpha injected into either the superior mesenteric or the femoral vein and by inhibiting of prostanoid synthesis with indomethacin. Release of the superior mesenteric artery occlusion caused a dramatic decrease in mean arterial blood pressure; an increase in mean portal venous pressure, and more than fivefold increases in plasma PGF2 alpha levels in superior mesenteric vein, right ventricle, and aorta. In spite of the decreased mean arterial blood pressure, postocclusion blood flow in the mesenteric artery did not fall below preocclusion values. Indomethacin in itself, significantly reduced plasma PGF2 alpha levels as well as intestinal blood flow and increased mean arterial blood pressure in animals without superior mesenteric artery occlusion. Furthermore, indomethacin attenuated the magnitude of postocclusion hypotension and completely prevented PGF2 alpha production during superior mesenteric artery occlusion shock. Exogenous PGF2 alpha 10 micrograms/kg injected into the superior mesenteric or femoral vein produced hypotension or hypertension, respectively. When PGF2 alpha was injected into the superior mesenteric vein, the plasma level of PGF2 alpha in the aorta was similar to that observed during superior mesenteric artery occlusion shock, whereas PGF2 alpha injected into the femoral vein gave a significantly higher concentration. Pulmonary metabolism of PGF2 alpha was significantly reduced in shock. The present results suggest that PGF2 alpha released by intestinal tissues might play an important role in shock caused by intestinal ischemia.
通过在肠系膜上动脉闭塞诱导的休克期间,测量麻醉犬肠系膜上静脉、右心室、主动脉和股静脉中的前列腺素F2α(PGF2α)水平,比较注入肠系膜上静脉或股静脉的外源性PGF2α的循环效应,并使用吲哚美辛抑制前列腺素合成,研究了PGF2α在肠源性循环休克中的作用。肠系膜上动脉闭塞导致平均动脉血压显著下降;平均门静脉压力升高,肠系膜上静脉、右心室和主动脉中的血浆PGF2α水平增加超过五倍。尽管平均动脉血压下降,但肠系膜动脉闭塞后的血流量并未降至闭塞前值以下。吲哚美辛本身可显著降低无肠系膜上动脉闭塞动物的血浆PGF2α水平以及肠血流量,并增加平均动脉血压。此外,吲哚美辛可减轻闭塞后低血压的程度,并完全阻止肠系膜上动脉闭塞性休克期间PGF2α的产生。向肠系膜上静脉或股静脉注射10微克/千克的外源性PGF2α分别产生低血压或高血压。当将PGF2α注入肠系膜上静脉时,主动脉中PGF2α的血浆水平与肠系膜上动脉闭塞性休克期间观察到的相似,而注入股静脉的PGF2α浓度显著更高。休克时PGF2α的肺代谢显著降低。目前的结果表明,肠道组织释放的PGF2α可能在肠缺血引起的休克中起重要作用。