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长期服用洋地黄会改变肠系膜血管反应性。

Chronic digitalis administration alters mesenteric vascular reactivity.

作者信息

Kim E H, Gewertz B L

出版信息

J Vasc Surg. 1987 Feb;5(2):382-9. doi: 10.1067/mva.1987.avs0050382.

Abstract

To characterize any digitalis-induced differences in intestinal blood flow autoregulation, we studied the circulatory responses of the rat intestine in control (n = 7) and chronically digitalized (n = 7) animals. Data were generated from denervated isoperfused small intestinal preparations. Arterial pressure, venous pressure, and oxygen consumption were continuously monitored. Determinations of intestinal blood flow allowed calculation of mesenteric vascular resistance and oxygen consumption. Animals underwent stepwise reductions in arterial pressure and acute venous hypertension (10 to 15 mm Hg). There were no differences in baseline hemodynamic or metabolic parameters in control (C) or digitalized (D) animals. Blood flow and oxygen consumption were autoregulated in both C and D rats until perfusion pressure decreased below 50 mm Hg. The response to acute venous hypertension was different. In D rats, venous hypertension resulted in increased vascular resistance (millimeters of mercury per milliliter per minute per 100 gm) [0.89 +/- 0.05 to 0.97 +/- 0.07; p less than 0.05], whereas C rats demonstrated no change [0.92 +/- 0.08 to 0.95 +/- 0.09]. The decrease in oxygen consumption in D rats (-14%) was slightly but significantly greater than that observed in C rats (-9%). Digitalized rats demonstrated a heightened myogenic response to acute venous hypertension with deleterious effects on vascular resistance and oxygen consumption. This reaction was intrinsic to the mesenteric circulation and not mediated by sympathetic nerves or central reflexes. Nonocclusive mesenteric ischemia in digitalized patients may reflect a similar abnormal response to the acute increases in portal pressure accompanying cardiac failure.

摘要

为了描述洋地黄引起的肠道血流自动调节的差异,我们研究了对照(n = 7)和长期使用洋地黄(n = 7)的大鼠肠道的循环反应。数据来自去神经支配的等灌注小肠标本。持续监测动脉压、静脉压和氧耗。通过测定肠道血流量来计算肠系膜血管阻力和氧耗。对动物进行动脉压逐步降低和急性静脉高压(10至15毫米汞柱)处理。对照(C)组和使用洋地黄(D)组动物的基线血流动力学或代谢参数没有差异。C组和D组大鼠的血流量和氧耗均能自动调节,直到灌注压降至50毫米汞柱以下。对急性静脉高压的反应有所不同。在D组大鼠中,静脉高压导致血管阻力增加(每100克每分钟每毫升毫米汞柱)[从0.89±0.05增至0.97±0.07;p<0.05],而C组大鼠则无变化[从0.92±0.08至0.95±0.09]。D组大鼠氧耗的降低(-14%)略大于但显著高于C组大鼠(-9%)。使用洋地黄的大鼠对急性静脉高压表现出增强的肌源性反应,对血管阻力和氧耗产生有害影响。这种反应是肠系膜循环所固有的,并非由交感神经或中枢反射介导。使用洋地黄的患者发生非闭塞性肠系膜缺血可能反映了对伴随心力衰竭的门静脉压力急性升高的类似异常反应。

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