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去氧肾上腺素输注期间迷走神经心肺压力反射激活

Vagal cardiopulmonary baroreflex activation during phenylephrine infusion.

作者信息

Minisi A J, Dibner-Dunlap M, Thames M D

机构信息

Department of Internal Medicine (Cardiology), Medical College of Virginia, Richmond.

出版信息

Am J Physiol. 1989 Nov;257(5 Pt 2):R1147-53. doi: 10.1152/ajpregu.1989.257.5.R1147.

Abstract

Phenylephrine infusion (PE) has been used to raise arterial pressure (BP) in order to investigate reflex responses mediated by sinoaortic baroreflexes (SAB). Increases in cardiac filling pressures have been reported during PE. Our experiments determined whether PE selectively activates SAB without activation of vagal cardiopulmonary baroreflexes (CPR). We measured changes in mean BP, mean pulmonary arterial pressure (PAP), and renal sympathetic nerve activity (RSNA) during PE in alpha-chloralose-anesthetized dogs before and after sinoaortic denervation (SAD; n = 10), selective vagotomy (n = 9), or SAD and vagotomy (n = 4). PE elevated both BP and PAP in all dogs studied. In dogs with SAB and CPR intact, RSNA was reflexively inhibited (% change RSNA: -76.3 +/- 4.7). In SAD dogs, inhibition of RSNA was significantly attenuated but not abolished (% change RSNA: -27.5 +/- 11.8). This inhibition after SAD correlated closely with increases in PAP. Small BP changes (10 mmHg) were associated with insignificant changes in PAP and RSNA. Volume expansion after SAD produced changes in PAP and RSNA similar to those produced by PE. After selective vagotomy, the sensitivity (% change RSNA/mmHg change BP) of the reflex elicited by PE was significantly decreased (-2.7 +/- 0.03 pre vs. -1.8 +/- 0.12 post; P = 0.01). PE failed to change RSNA after combined SAD and vagotomy. We conclude that vagal CPR contribute to reflex inhibition of RSNA during PE except when elevations of BP are small.

摘要

去氧肾上腺素输注(PE)已被用于升高动脉血压(BP),以研究由窦主动脉压力反射(SAB)介导的反射反应。据报道,在PE期间心脏充盈压会升高。我们的实验确定了PE是否能选择性激活SAB而不激活迷走神经心肺压力反射(CPR)。我们在α-氯醛糖麻醉的犬中,于窦主动脉去神经支配(SAD;n = 10)、选择性迷走神经切断术(n = 9)或SAD加迷走神经切断术(n = 4)前后,测量了PE期间平均BP、平均肺动脉压(PAP)和肾交感神经活动(RSNA)的变化。在所有研究的犬中,PE均使BP和PAP升高。在SAB和CPR完整的犬中,RSNA受到反射性抑制(RSNA变化百分比:-76.3±4.7)。在SAD犬中,RSNA的抑制明显减弱但未消除(RSNA变化百分比:-27.5±11.8)。SAD后的这种抑制与PAP的升高密切相关。小的BP变化(10 mmHg)与PAP和RSNA的微小变化相关。SAD后扩容引起的PAP和RSNA变化与PE引起的相似。选择性迷走神经切断术后,PE引发的反射敏感性(RSNA变化百分比/mmHg BP变化)显著降低(术前-2.7±0.03 vs. 术后-1.8±0.12;P = 0.01)。SAD加迷走神经切断术后,PE未能改变RSNA。我们得出结论,除了BP升高较小时,迷走神经CPR在PE期间有助于对RSNA的反射性抑制。

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