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全身血管自动调节增强了对血管收缩剂的升压反应。

Systemic vascular autoregulation amplifies pressor responses to vasoconstrictor agents.

作者信息

Metting P J, Stein P M, Stoos B A, Kostrzewski K A, Britton S L

机构信息

Department of Physiology, Medical College of Ohio, Toledo 43699.

出版信息

Am J Physiol. 1989 Jan;256(1 Pt 2):R98-105. doi: 10.1152/ajpregu.1989.256.1.R98.

Abstract

Experiments were performed in seven conscious dogs to evaluate the contribution of total systemic autoregulation to the increase in mean arterial pressure (MAP) produced by the intravenous administration of pressor agents. Each dog was instrumented for the measurement of aortic pressure, central venous pressure, and cardiac output, and all dogs received hexamethonium to block autonomic ganglionic transmission. Angiotensin II (ANG II), arginine vasopressin (AVP), or norepinephrine (NE) were titrated over a 15- to 20-min period until MAP was increased to a new steady-state value approximately 50-55% above the normotensive control. Then while a constant infusion of the pressor agents was maintained, MAP was controlled via a gravity reservoir for 15-min periods at either the hypertensive value or at the animal's normotensive value. With all three pressor agents, total peripheral resistance (TPR) was greater when MAP was controlled at the hypertensive value than when the vasculature was protected from the elevated pressure by controlling MAP at the normotensive value. Thus a portion of the increase in TPR during the infusion of ANG II, AVP, or NE was due to autoregulatory-mediated vasoconstriction elicited by the increase in MAP. The fractions of the increases in TPR and MAP contributed by primary vasoconstriction vs. autoregulation were determined from the pressure-flow relationships. The pressure-induced increases in TPR accounted for 74% of the total increase in MAP produced by AVP, 62% of the pressor response to NE, and 34% of the response to ANG II. These results demonstrate that the direct vasoconstrictor effects of pressor agents can be significantly amplified by secondary autoregulatory responses.

摘要

在七只清醒犬身上进行了实验,以评估全身自动调节对静脉注射升压药所引起的平均动脉压(MAP)升高的作用。每只犬都安装了测量主动脉压、中心静脉压和心输出量的仪器,并且所有犬都接受六甲铵以阻断自主神经节传递。在15至20分钟内滴定给予血管紧张素II(ANG II)、精氨酸加压素(AVP)或去甲肾上腺素(NE),直到MAP升高到比正常血压对照值高出约50 - 55%的新稳态值。然后在持续输注升压药的同时,通过重力储液器将MAP在高血压值或动物的正常血压值下控制15分钟。对于所有三种升压药,当MAP控制在高血压值时,总外周阻力(TPR)大于通过将MAP控制在正常血压值来保护血管系统免受升高压力影响时的TPR。因此,在输注ANG II、AVP或NE期间TPR增加的一部分是由于MAP升高引起的自动调节介导的血管收缩。根据压力 - 流量关系确定了原发性血管收缩与自动调节对TPR和MAP升高的贡献比例。压力诱导的TPR升高分别占AVP引起的MAP总升高的74%、NE升压反应的62%和ANG II反应的34%。这些结果表明,升压药的直接血管收缩作用可被继发性自动调节反应显著放大。

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