Lübbe A S, Garrison R N, Harris P D, Cryer H M
Department of Physiology, School of Medicine, University of Louisville, Kentucky 40292.
J Surg Res. 1989 Feb;46(2):108-17. doi: 10.1016/0022-4804(89)90212-6.
Altered vascular reactivity to numerous vasoactive substances in hypertension formed the basis for studying the in vivo microcirculation of skeletal muscle tissue during high cardiac output bacteremia and low cardiac output sepsis. Large and small arteriole and venule diameters of the cremaster muscle were measured via videomicroscopy in normotensive and 1K-1C-renovascular hypertensive rats before and after the infusion of live Escherichia coli bacteria. During hyperdynamic bacteremia and during hypodynamic sepsis, large arterioles constricted and small arterioles dilated in normotensive animals. During hyperdynamic bacteremia, this differential arteriolar response was blunted in hypertension. In hypodynamic sepsis, large arterioles did constrict in the hypertensive animals, but small arteriolar dilation was still blunted. Sodium-nitroprusside, a postreceptor acting agent applied locally, maximally dilated small arterioles to the same level in all groups to indicate that the ability of vascular smooth muscle to relax is intact in hypertension. We conclude that the failure of the small arterioles to dilate during sepsis in hypertension is not due to a loss of vascular smooth muscle function, but that hypertension may functionally alter arteriolar reactivity at the receptor and/or endothelial level to interfere with E. coli-mediated responses in the skeletal muscle microvasculature.
高血压状态下血管对多种血管活性物质的反应性改变,构成了研究高心输出量菌血症和低心输出量脓毒症期间骨骼肌组织体内微循环的基础。通过视频显微镜测量正常血压大鼠和1K-1C肾血管性高血压大鼠在输注活大肠杆菌前后提睾肌的大、小动脉和静脉直径。在高动力菌血症和低动力脓毒症期间,正常血压动物的大动脉收缩,小动脉扩张。在高动力菌血症期间,高血压动物的这种动脉差异反应减弱。在低动力脓毒症期间,高血压动物的大动脉确实收缩,但小动脉扩张仍减弱。局部应用的受体后作用剂硝普钠使所有组的小动脉最大程度扩张至相同水平,表明高血压状态下血管平滑肌的舒张能力完好。我们得出结论,高血压患者在脓毒症期间小动脉不能扩张并非由于血管平滑肌功能丧失,而是高血压可能在受体和/或内皮水平功能性改变动脉反应性,从而干扰骨骼肌微血管中大肠杆菌介导的反应。