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犬椎动脉内注射高渗造影剂后的心血管反应。

Cardiovascular responses to the intravertebral artery injection of hypertonic contrast media in the dog.

作者信息

Hayakawa K, Morris T W, Katzberg R W, Fischer H W

出版信息

Invest Radiol. 1985 Mar-Apr;20(2):217-21. doi: 10.1097/00004424-198503000-00022.

Abstract

Central nervous system-mediated cardiovascular responses to contrast medium (CM) are believed the result of a vagal or of a sympatholytic response; these effects may be enhanced in the setting of dehydration. The purpose of this investigation was to evaluate neurally mediated effects of intravertebral artery CM injections on blood pressure (BP), heart rate (HR) and regional vascular resistances in euvolemic and dehydrated dogs. Animal preparation consisted of food and water ad libitum (n = 7) vs. 2.0 ml/kg i.m. furosemide and 48 hours thirsting (n = 7). During pentobarbital anesthesia BP, HR and renal and femoral blood flows were continuously monitored and meglumine iothalamate 60% (1 ml/kg) injected via a left vertebral artery catheter at 3 ml/sec; matched volume injections of normal saline served as control. Decreases in BP, HR and femoral and renal vascular resistances post CM injection were observed in the first 10 seconds before the CM had reached the systemic circulation. Significant decreases in both BP (-10.6 +/- 1.7%) and HR (-11.5 +/- 1.6%) post CM injection were noted with dehydration (n = 7). In the euvolemic dogs (n = 7) the decrease in HR (-7.3 +/- 2.0%) was significant but the decrease in BP (-3.9 +/- 2.4%) was not. The decrease in femoral vascular resistance was -22.7 +/- 9.0% in euvolemic dogs and -21.9 +/- 8.8% in dehydrated dogs. No significant changes were noted with the intravertebral artery injections of normal saline in control euvolemic and dehydrated animals. The early cardiovascular responses to CM suggest a direct action on the vasomotor center of the medulla. The effects on BP and HR are more severe in the dehydrated than in the euvolemic state.

摘要

中枢神经系统介导的对造影剂(CM)的心血管反应被认为是迷走神经或交感神经抑制反应的结果;在脱水情况下,这些效应可能会增强。本研究的目的是评估在血容量正常和脱水的犬中,经椎动脉注射造影剂对血压(BP)、心率(HR)和局部血管阻力的神经介导作用。动物准备分为自由饮食和饮水组(n = 7)与肌肉注射速尿2.0 ml/kg和禁水48小时组(n = 7)。在戊巴比妥麻醉期间,持续监测血压、心率以及肾和股动脉血流,并通过左椎动脉导管以3 ml/秒的速度注射60%的碘他拉葡胺(1 ml/kg);注射等体积的生理盐水作为对照。在造影剂到达体循环之前的最初10秒内,观察到注射造影剂后血压、心率以及股动脉和肾血管阻力下降。脱水组(n = 7)注射造影剂后血压(-10.6 +/- 1.7%)和心率(-11.5 +/- 1.6%)均显著下降。血容量正常的犬(n = 7)心率下降(-7.3 +/- 2.0%)显著,但血压下降(-3.9 +/- 2.4%)不显著。血容量正常的犬股血管阻力下降-22.7 +/- 9.0%,脱水犬为-21.9 +/- 8.8%。在对照的血容量正常和脱水动物中,经椎动脉注射生理盐水未观察到显著变化。对造影剂的早期心血管反应提示其对延髓血管运动中枢有直接作用。脱水状态下对血压和心率的影响比血容量正常状态下更严重。

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