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可乐定对脑血流量及动脉二氧化碳反应的影响。

Effects of clonidine on cerebral blood flow and the response to arterial CO2.

作者信息

Kanawati I S, Yaksh T L, Anderson R E, Marsh R W

出版信息

J Cereb Blood Flow Metab. 1986 Jun;6(3):358-65. doi: 10.1038/jcbfm.1986.60.

DOI:10.1038/jcbfm.1986.60
PMID:3011828
Abstract

CBF, as measured by the clearance of 133Xe or 85Kr in the pentobarbital-anesthetized cat, displays a monotonic increase as the PaCO2 is elevated over a range of 20-60 mm Hg (slope Xe, 1.65 +/- 0.14 ml/100g/min/mm Hg; slope Kr, 1.40 +/- 0.11 ml/100 g/min/mm Hg). Clonidine (20 micrograms/kg i.v.), a centrally acting, alpha 2-preferring agonist, reduced the slope of the PaCO2-CBF response functions for Xe and Kr by 70 and 64%, respectively. Clonidine reduced normocarbic CBF-Xe by 36%, but had no effect on normocarbic CBF-Kr. ST-91, a polar structural analog of clonidine that does not cross the blood-brain barrier, did not reproduce the effects of clonidine when administered at an equivalent dose. This indicates that the effects of clonidine observed were secondary to its action on central rather than peripheral sites. In addition to the effects on the clearance of CBF markers, clonidine reduced the increased MABP otherwise evoked by elevated PaCO2. Reduction in the MABP response to PaCO2 did not account for the lowering of CBF during hypercarbia. In separate experiments where MABP was elevated to correspond with the PaCO2-MABP response observed in the absence of clonidine, a comparable reduction in the slope of the PaCO2 response was also observed. In addition, the pressure autoregulatory response was unaltered after clonidine treatment. These observations suggest that the central action of alpha 2-receptors on the CBF-CO2 response cannot be attributed to an altered perfusion pressure.

摘要

通过在戊巴比妥麻醉的猫中用133Xe或85Kr清除率测量的脑血流量(CBF),在20 - 60 mmHg范围内随着动脉血二氧化碳分压(PaCO2)升高呈单调增加(Xe斜率,1.65±0.14 ml/100g/min/mmHg;Kr斜率,1.40±0.11 ml/100g/min/mmHg)。可乐定(20微克/千克静脉注射),一种中枢作用、优先作用于α2的激动剂,分别使Xe和Kr的PaCO2 - CBF反应函数斜率降低了70%和64%。可乐定使正常碳酸血症时的CBF - Xe降低了36%,但对正常碳酸血症时的CBF - Kr没有影响。ST - 91,一种不穿过血脑屏障的可乐定极性结构类似物,以等效剂量给药时未重现可乐定的作用。这表明观察到的可乐定的作用是其对中枢而非外周部位作用的继发效应。除了对CBF标志物清除率的影响外,可乐定还降低了否则会由升高的PaCO2引起的平均动脉血压(MABP)升高。MABP对PaCO2反应的降低并不能解释高碳酸血症期间CBF的降低。在单独的实验中,将MABP升高至与在没有可乐定的情况下观察到的PaCO2 - MABP反应相对应时,也观察到PaCO2反应斜率有类似降低。此外,可乐定治疗后压力自动调节反应未改变。这些观察结果表明,α2受体对CBF - CO2反应的中枢作用不能归因于灌注压力的改变。

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