Takeda Shohei, Tomaru Teruaki, Inada Yutaka
Department of Anesthesiology, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, 227, Yokohama, Japan.
J Anesth. 1997 Sep;11(3):202-207. doi: 10.1007/BF02480038.
Calcitonin gene-related peptide (CGRP) is an endogenous 37-amino-acid peptide which is a powerful vasodilator of the splanchnic circulation. To elucidate the effects of CGRP-induced hypotension on the organ blood flow, we compared the renal, hepatic, and pancreatic organ flows of CGRP-induced hypotension with those of trimetaphan (TMP) in halothane-anesthetized dogs.
Systemic hemodynamics and organ blood flow were determined in 18 mongrel dogs allocated to one of two groups: CGRP group (n=10) and TMP group (n=8). CGRP of TMP was infused at a rate sufficient to decrease the mean arterial pressure (MAP) to near 60 mmHg from the baseline values for a 60 min-hypotensive period. Organ blood flow was measured using the hydrogen clearance technique.
The decrease in MAP was approximately 50% of baseline values (P<0.01). The hypotension induced by either CGRP or TMP was associated with a reduction (P<0.01) in systemic vascular resistance in both groups. Cardiac index (CI) in the CGRP group did not change significantly throughout the experiment. On the other hand, CI decreased at 30 min (P<0.01) and 60 min (P<0.01) during the hypotensive period in the TMP group. No changes were observed in renal, hepatic, and pancreatic blood flows in the CGRP group. Renal blood flow in the TMP group did not change significantly throughout the experiment. In contrast, hepatic blood flow resulted in a significant decrease (P<0.01) during TMP-induced hypotension. Pancreatic blood flow decreased during the hypotensive period (P<0.01) and at 30 min (P<0.05) after termination of TMP.
These findings show that CGRP does not adversely affect renal, hepatic, and pancreatic organ blood flows even in the presence of profound hypotension in halothane-anesthetized dogs. The results of this study suggest that CGRP may preserve organ blood flow during induced hypotension.
降钙素基因相关肽(CGRP)是一种内源性37个氨基酸的肽,是内脏循环的强效血管扩张剂。为阐明CGRP诱导的低血压对器官血流的影响,我们比较了氟烷麻醉犬中CGRP诱导低血压与阿方那特(TMP)诱导低血压时的肾、肝和胰腺器官血流。
将18只杂种犬分为两组:CGRP组(n = 10)和TMP组(n = 8),测定其全身血流动力学和器官血流。以足以使平均动脉压(MAP)从基线值降至接近60 mmHg的速率输注CGRP或TMP,持续60分钟的低血压期。使用氢清除技术测量器官血流。
MAP下降约为基线值的50%(P<0.01)。CGRP或TMP诱导的低血压均与两组全身血管阻力降低(P<0.01)相关。CGRP组的心脏指数(CI)在整个实验过程中无显著变化。另一方面,TMP组在低血压期30分钟(P<0.01)和60分钟(P<0.01)时CI降低。CGRP组的肾、肝和胰腺血流无变化。TMP组的肾血流在整个实验过程中无显著变化。相比之下,TMP诱导低血压时肝血流显著减少(P<0.01)。低血压期胰腺血流减少(P<0.01),TMP输注终止后30分钟时也减少(P<0.05)。
这些发现表明,即使在氟烷麻醉犬出现严重低血压的情况下,CGRP也不会对肾、肝和胰腺器官血流产生不利影响。本研究结果表明,CGRP可能在诱导低血压期间维持器官血流。