Moruzzi P, Sganzerla P, Guazzi M D
Istituto di Cardiologia, Università di Milano.
G Ital Cardiol. 1988 Apr;18(4):301-7.
In man, the extent, the physiological role and even the existence of neural influences on the pulmonary vasomotility are not defined. A major obstacle to these evaluations is passive adaptation of the lung vessels to changes in flow, making it hard to separate the active from the passive component of vasomotion during adrenergic activation. In this study, which was carried out in 8 patients during diagnostic procedures, the inflation of a balloon in the inferior vena cava was utilized to reduce blood flows through the lungs and to buffer its changes consequent to stimulation of the adrenergic system. Neural activation was obtained with the mental arithmetic and the cold pressor tests. When venous return was unimpeded, cardiac output rose by 2,060 ml during the former and remained stable during the latter test, and arteriolar resistance in the pulmonary circuit was significantly reduced and slightly increased, respectively. Under vena cava obstruction, cardiac output decreased in the baseline by 600 ml; it rose by 925 ml during the arithmetic test and again remained stable during the cold test; pulmonary arteriolar resistance was unchanged since before obstruction in the baseline and was significantly augmented by both test. These observations support the view that lung blood vessels in man are sensitive to adrenergic influences and the vasoconstrictor component of these becomes effective in circumstances in which the flow through the lungs reduced. The physiological importance of these influences remains unclear.
在人类中,神经对肺血管运动的影响程度、生理作用乃至其存在与否都尚未明确。进行这些评估的一个主要障碍是肺血管会被动适应血流变化,这使得在肾上腺素能激活过程中难以区分血管运动的主动成分和被动成分。在这项针对8名患者在诊断过程中开展的研究中,通过在下腔静脉内充盈气囊来减少流经肺部的血流量,并缓冲因肾上腺素能系统刺激而导致的血流量变化。通过心算和冷加压试验实现神经激活。当静脉回流不受阻碍时,在前一项试验中心输出量增加了2060毫升,在后一项试验中保持稳定,肺循环中的小动脉阻力分别显著降低和略有增加。在下腔静脉阻塞的情况下,基线时心输出量减少了600毫升;在心算试验期间增加了925毫升,在冷试验期间再次保持稳定;肺小动脉阻力在基线时自阻塞前起未发生变化,而在两项试验中均显著增加。这些观察结果支持以下观点:人类的肺血管对肾上腺素能影响敏感,并且这些影响中的血管收缩成分在流经肺部的血流减少的情况下会变得有效。这些影响的生理重要性仍不清楚。