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失血性休克时血浆和组织中组胺水平的变化

Histamine level changes in the plasma and tissues in hemorrhagic shock.

作者信息

Nagy S, Nagy A, Adamicza A, Szabó I, Tárnoky K, Traub A

出版信息

Circ Shock. 1986;18(3):227-39.

PMID:3516438
Abstract

Histamine (H) levels have been reported during various types of shock, but there is a paucity of such data during hemorrhagic shock. The present study demonstrates a rapid, severalfold increase of radioenzymatically measured plasma H in conscious and anesthetized dogs subjected to experimental hemorrhagic shock. Shock was elicited by bleeding to a mean arterial blood pressure of 5.3 kPa, and maintained until 20% of the maximal bleeding volume (MBV) was taken back by the animal. The corresponding figures in the anesthetized group were 4 kPa and 30% uptake. The increased H level persisted in both groups during hypovolemia and remained above the control value following reinfusion. Survival was examined in the conscious group. At MBV, survivors had significantly higher H levels and H/norepinephrine and H/renin activity ratios in the plasma than nonsurvivors. The H level increased in the liver, lungs, spleen, left atrium and ventricle, and blood vessel walls (superior mesenteric artery, small jejunal arteries and veins, femoral artery and vein). The H/norepinephrine ratio increased in the left ventricle and blood vessel walls. The increase of H in the blood plasma and blood vessels during hemorrhagic shock may exemplify a counterregulation against excessive vasoconstriction and could be a positive factor in survival.

摘要

已有报道称在各种类型的休克过程中组胺(H)水平会发生变化,但关于失血性休克期间此类数据却很少。本研究表明,在经历实验性失血性休克的清醒和麻醉犬中,用放射酶法测得的血浆H会迅速出现数倍的增加。通过放血使平均动脉血压降至5.3 kPa来引发休克,并维持至动物回输20%的最大出血量(MBV)。麻醉组的相应数值分别为4 kPa和30%回输量。在低血容量期间,两组的H水平均持续升高,再灌注后仍高于对照值。对清醒组进行了存活情况检查。在达到MBV时,存活者血浆中的H水平以及H/去甲肾上腺素和H/肾素活性比值显著高于未存活者。肝脏、肺、脾、左心房和心室以及血管壁(肠系膜上动脉、空肠小动脉和静脉、股动脉和静脉)中的H水平均升高。左心室和血管壁中的H/去甲肾上腺素比值升高。失血性休克期间血浆和血管中H的增加可能是对过度血管收缩的一种反调节,并且可能是存活的一个积极因素。

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