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[钾离子、钠离子和钙离子在烧伤休克及挤压综合征中血浆心脏抑制作用中的作用]

[Role of K+, Na+, and Ca2+ ions in the cardiodepressive action of blood plasma in burn shock and the crush syndrome].

作者信息

Vornovitskiĭ E G, Len'kova N A, Zairov D K

出版信息

Biull Eksp Biol Med. 1985 Jan;99(1):19-22.

PMID:3967065
Abstract

Ion-selective electrodes were employed to measure the concentration of K+, Na+ and Ca2+ in blood plasma of rabbits with burn shock or crush syndrome (CS). No significant changes in the plasma concentration of Na+, and Ca2+ were found under both pathological conditions. The plasma concentration of K+ in burn shock significantly increased from 3.06 +/- 0.73 (control) to 5.28 +/- 2.65 mM (n = 10), whereas in CS from 3.42 +/- 1.03 to 4.92 +/- 1,29 mM (n = 8). The rise of K+ concentration in the control plasma to the maximal values seen in the "burn" and "syndrome" plasma led to an increase in the duration of intracellular action potentials (AP) but did not substantially change the amplitude of isometric contractions of the papillary muscles of rabbit heart. Meanwhile the similar rise of the duration of intracellular AP during perfusion of the papillary muscles with the "burn" and "syndrome" plasma was accompanied by an appreciable drop of the amplitude of isometric contractions. It is suggested that elevation of K+ concentration in blood plasma, inducing an increase in the duration of intracellular AP of cardiocytes may be responsible for changes in the ECG in burn and CS. At the same time inhibition of myocardial contractility in burn shock and CS is virtually not linked with hyperkalemia.

摘要

采用离子选择性电极测量烧伤休克或挤压综合征(CS)家兔血浆中K +、Na +和Ca2 +的浓度。在这两种病理状态下,血浆中Na +和Ca2 +的浓度均未发现明显变化。烧伤休克时血浆K +浓度从3.06±0.73(对照)显著升高至5.28±2.65 mM(n = 10),而在挤压综合征中则从3.42±1.03升高至4.92±1.29 mM(n = 8)。对照血浆中K +浓度升高至“烧伤”和“综合征”血浆中所见的最大值,导致细胞内动作电位(AP)持续时间增加,但兔心乳头肌等长收缩幅度没有实质性变化。同时,在用“烧伤”和“综合征”血浆灌注乳头肌期间,细胞内AP持续时间的类似增加伴随着等长收缩幅度的明显下降。提示血浆中K +浓度升高,导致心肌细胞内AP持续时间增加,可能是烧伤和挤压综合征中心电图变化的原因。同时,烧伤休克和挤压综合征中心肌收缩力的抑制实际上与高钾血症无关。

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