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心脏压塞所致休克时的体液变化

Humoral changes in shock induced by cardiac tamponade.

作者信息

Kaszaki J, Nagy S, Tárnoky K, Laczi F, Vecsernyés M, Boros M

机构信息

Institute of Experimental Surgery, Szent-Györgyi Albert Medical University, Szeged, Hungary.

出版信息

Circ Shock. 1989 Oct;29(2):143-53.

PMID:2684445
Abstract

Cardiac tamponade was induced in dogs by the infusion of saline into the pericardial cavity. The mean arterial pressure dropped to approximately one-third and the cardiac output to one-fourth of the control level. This was accompanied by the release of vasoactive humoral mediators. Among the vasoconstrictor mediators measured in the plasma, the greatest rise during early tamponade occurred in vasopressin concentrations. Considerable elevations of epinephrine and nonrepinephrine concentrations and plasma renin activity were also demonstrated, these mediators reaching their maximum levels in late tamponade. This study for the first time demonstrates significant rises in plasma thromboxane B2 and histamine levels in cardiac tamponade. The histamine level elevation was greater in the portal venous blood than in the arterial blood. It is suggested that histamine may play a counterregulatory role in cardiac tamponade by attenuating excessive vasoconstriction caused by the activation of various vasoconstrictor systems.

摘要

通过向心包腔内注入生理盐水在犬身上诱发心脏压塞。平均动脉压降至约为对照水平的三分之一,心输出量降至对照水平的四分之一。这伴随着血管活性体液介质的释放。在血浆中检测到的血管收缩介质中,早期心脏压塞期间升高幅度最大的是血管加压素浓度。肾上腺素、去甲肾上腺素浓度和血浆肾素活性也有显著升高,这些介质在晚期心脏压塞时达到最高水平。本研究首次证明心脏压塞时血浆血栓素B2和组胺水平显著升高。门静脉血中组胺水平的升高幅度大于动脉血。提示组胺可能通过减弱各种血管收缩系统激活所致的过度血管收缩,在心脏压塞中发挥反调节作用。

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