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主肺动脉扩张所致反射性肺血管收缩的逆转。

Reversal of reflex pulmonary vasoconstriction induced by main pulmonary arterial distension.

作者信息

Juratsch C E, Grover R F, Rose C E, Reeves J T, Walby W F, Laks M M

出版信息

J Appl Physiol (1985). 1985 Apr;58(4):1107-14. doi: 10.1152/jappl.1985.58.4.1107.

Abstract

Distension of the main pulmonary artery (MPA) induces pulmonary hypertension, most probably by neurogenic reflex pulmonary vasoconstriction, although constriction of the pulmonary vessels has not actually been demonstrated. In previous studies in dogs with increased pulmonary vascular resistance produced by airway hypoxia, exogenous arachidonic acid has led to the production of pulmonary vasodilator prostaglandins. Hence, in the present study, we investigated the effect of arachidonic acid in seven intact anesthetized dogs after pulmonary vascular resistance was increased by MPA distention. After steady-state pulmonary hypertension was established, arachidonic acid (1.0 mg/min) was infused into the right ventricle for 16 min; 15-20 min later a 16-mg bolus of arachidonic acid was injected. MPA distension was maintained throughout the study. Although the infusion of arachidonic acid significantly lowered the elevated pulmonary vascular resistance induced by MPA distension, the pulmonary vascular resistance returned to control levels only after the bolus injection of arachidonic acid. Notably, the bolus injection caused a biphasic response which first increased the pulmonary vascular resistance transiently before lowering it to control levels. In dogs with resting levels of pulmonary vascular resistance, administration of arachidonic acid in the same manner did not alter the pulmonary vascular resistance. It is concluded that MPA distension does indeed cause reflex pulmonary vasoconstriction which can be reversed by vasodilator metabolites of arachidonic acid. Even though this reflex may help maintain high pulmonary vascular resistance in the fetus, its function in the adult is obscure.

摘要

主肺动脉(MPA)扩张可诱发肺动脉高压,很可能是通过神经源性反射性肺血管收缩,尽管尚未实际证实肺血管发生了收缩。在先前对因气道缺氧导致肺血管阻力增加的犬类进行的研究中,外源性花生四烯酸可导致肺血管扩张性前列腺素的产生。因此,在本研究中,我们在通过MPA扩张增加肺血管阻力后,研究了花生四烯酸对7只完整麻醉犬的影响。在建立稳定状态的肺动脉高压后,将花生四烯酸(1.0毫克/分钟)注入右心室,持续16分钟;15 - 20分钟后,静脉推注16毫克花生四烯酸。在整个研究过程中,MPA扩张一直维持。尽管输注花生四烯酸显著降低了由MPA扩张引起的升高的肺血管阻力,但仅在静脉推注花生四烯酸后,肺血管阻力才恢复到对照水平。值得注意的是,静脉推注引起了双相反应,首先短暂增加肺血管阻力,然后将其降至对照水平。在肺血管阻力处于静息水平的犬类中,以相同方式给予花生四烯酸不会改变肺血管阻力。结论是,MPA扩张确实会引起反射性肺血管收缩,而花生四烯酸的血管扩张性代谢产物可使其逆转。尽管这种反射可能有助于维持胎儿的高肺血管阻力,但其在成人中的功能尚不清楚。

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