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清醒门静脉高压大鼠递增剂量普萘洛尔后门静脉压力与全身血流动力学变化之间的差异

Discrepancy between portal pressure and systemic hemodynamic changes after incremental doses of propranolol in awake portal hypertensive rats.

作者信息

Koshy A, Girod C, Lee S S, Hadengue A, Cerini R, Lebrec D

机构信息

Unité de Recherches de Physiopathologie Hépatique (INSERM U-24), Hôpital Beaujon, Clichy, France.

出版信息

Hepatology. 1989 Feb;9(2):269-73. doi: 10.1002/hep.1840090218.

Abstract

The effects of increasing doses of propranolol were studied in awake portal hypertensive rats in order to elucidate the relative effects of the beta-blocker on systemic and splanchnic circulation. Hemodynamic responses to 0.1, 0.2 and 0.4 mg per min infusions of propranolol were compared with placebo in awake rats with portal hypertension due to portal vein stenosis. Heart rate significantly and progressively decreased from 356 +/- 13 to 293 +/- 10 beats per min (mean +/- S.E.). Cardiac output significantly decreased from 54 +/- 3 to 42 +/- 3 ml per min per 100 gm body weight at the highest dose. Significant decrease in portal tributary blood flow from 27 +/- 1 to 18 +/- 1 ml per min, at 0.4 mg per min dose, was due not only to the decrease in cardiac output but also to a significant increase in portal tributary vascular resistance from 269 +/- 17 to 368 +/- 31 dyne per sec per cm5 x 10(3). However, portal pressure showed only an insignificant decrease from 14.9 +/- 1.1 to 14.1 +/- 1.4 mmHg. The reduction in portal pressure being minimal, in spite of a significant decrease in portal tributary blood flow, is explained by an increase in combined hepatic and collateral resistance from 44 +/- 2 to 66 +/- 4 dyne per sec per cm5 x 10(3), p less than 0.05, at 0.4 mg per min dose. We conclude that the systemic and splanchnic effects of propranolol show discrepancy at two levels.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

为了阐明β受体阻滞剂对全身和内脏循环的相对影响,对清醒的门静脉高压大鼠进行了递增剂量普萘洛尔的效应研究。将每分钟输注0.1、0.2和0.4毫克普萘洛尔的血流动力学反应与因门静脉狭窄导致门静脉高压的清醒大鼠中的安慰剂进行比较。心率从356±13显著且逐渐下降至293±10次/分钟(平均值±标准误)。在最高剂量时,心输出量从每100克体重每分钟54±3显著降至42±3毫升。在每分钟0.4毫克剂量时,门静脉分支血流量从每分钟27±1显著降至18±1毫升,这不仅归因于心输出量的减少,还归因于门静脉分支血管阻力从每秒每平方厘米5×10(3)达因269±17显著增加至368±31达因。然而,门静脉压力仅从14.9±1.1降至14.1±1.4毫米汞柱,降幅不显著。尽管门静脉分支血流量显著减少,但门静脉压力降低最小,这是由于在每分钟0.4毫克剂量时,肝脏和侧支联合阻力从每秒每平方厘米5×10(3)达因44±2增加至66±4达因,p<0.05。我们得出结论,普萘洛尔的全身和内脏效应在两个层面上存在差异。(摘要截断于250字)

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