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静息状态下急性低氧血症患者的肝内脏功能。

Hepatic splanchnic function in acutely hypoxemic humans at rest.

作者信息

Blackmon J R, Rowell L B

出版信息

Am J Physiol. 1986 Nov;251(5 Pt 2):R887-92. doi: 10.1152/ajpregu.1986.251.5.R887.

Abstract

Splanchnic metabolism of O2, glucose, and lactate was studied in five normal men during rest while breathing air, 10.4% O2 [arterial O2 partial pressure (PaO2) = 34.8 Torr], and in four men breathing 7.6% O2 (PaO2 = 27.0 Torr). Despite reduction in arterial O2 content to 10.7 ml/100 ml, splanchnic O2 uptake (VO2) and arteriovenous O2 difference remained constant through a fall in hepatic venous O2 content to 7.3 ml/100 ml. Hepatic release of glucose and uptake of lactate were unaffected by either moderate or severe hypoxemia. In five other men hepatic extraction efficiency, removal rate, and clearance of norepinephrine (NE) and epinephrine (E) (radioenzymatic assay) were determined, while air and 10.27% O2 were breathed, and while NE was infused over widely ranging rates (constant in a given subject). Over arterial concentrations of 1.8-17 ng/ml for NE and 0.03-0.3 ng/ml for E, splanchnic removal was closely related to arterial concentration and was unaffected by hypoxemia. NE extraction efficiency rose from 60 (control) to 94% (during infusion in normoxia and hypoxemia); E extraction efficiency remained constant at 85% under all conditions. Hepatic clearances of both NE (556-824 ml/min) and E (630-804 ml/min) were unaffected by hypoxemia. The only observed deficiency in hepatic function was a significant decrease in extraction of indocyanine green in all 10 subjects at both levels of hypoxemia.

摘要

在五名正常男性静息呼吸空气、呼吸含10.4%氧气(动脉血氧分压[PaO2]=34.8托)时,以及在四名呼吸含7.6%氧气(PaO2=27.0托)的男性中,研究了内脏对氧气、葡萄糖和乳酸的代谢情况。尽管动脉血氧含量降至10.7毫升/100毫升,但通过肝静脉血氧含量降至7.3毫升/100毫升,内脏氧摄取量(VO2)和动静脉氧差保持恒定。葡萄糖的肝脏释放和乳酸的摄取不受中度或重度低氧血症的影响。在另外五名男性中,测定了在呼吸空气和10.27%氧气时,以及在以广泛不同速率输注去甲肾上腺素(NE)(在给定受试者中恒定)时,肝脏对去甲肾上腺素(NE)和肾上腺素(E)(放射酶法测定)的提取效率、清除率和清除量。在NE动脉浓度为1.8 - 17纳克/毫升和E动脉浓度为0.03 - 0.3纳克/毫升的范围内,内脏清除与动脉浓度密切相关,且不受低氧血症影响。NE提取效率从60%(对照)升至94%(常氧和低氧血症输注期间);E提取效率在所有条件下均保持在85%不变。两种NE(556 - 824毫升/分钟)和E(630 - 804毫升/分钟)的肝脏清除率均不受低氧血症影响。在所有10名受试者的两个低氧血症水平下,唯一观察到的肝功能缺陷是吲哚菁绿提取显著降低。

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