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选择性肠系膜上动脉输注与外周静脉输注胰高血糖素的血流动力学效应比较

Comparative hemodynamic effects of selective superior mesenteric arterial and peripheral intravenous glucagon infusions.

作者信息

Wright C D, Kazmers A, Whitehouse W M, Stanley J C

出版信息

J Surg Res. 1985 Sep;39(3):230-6. doi: 10.1016/0022-4804(85)90147-7.

Abstract

This experiment was designed to determine whether any hemodynamic benefits attend administration of equal pharmacologic doses of glucagon (1 micrograms/kg/m) by continuous intravenous infusion (Group I, n = 6) versus selective intraarterial infusion (Group II, n = 6) via the superior mesenteric artery (SMA) in dogs. Cardiac output, heart rate, mean arterial pressure, total peripheral resistance, pulmonary vascular resistance, superior mesenteric artery flow (SMAQ), SMA vascular resistance, and portal venous pressure were measured at baseline (BL) and at 5, 15, 30, and 45 min during glucagon infusion. SMAQ virtually doubled at 5 min from a baseline of 570 +/- 60 ml/min to 1158 +/- 146 ml/min in Group I (P less than 0.001), and from a baseline of 527 +/- 171 to 1018 +/- 331 ml/min in Group II (P less than 0.002). SMAQ was significantly higher in Group I at 30 and 45 min compared to Group II (P less than 0.03) despite similar peripheral plasma glucagon levels. SMA vascular resistance was significantly lowered in both groups, with a greater reduction occurring during intravenous glucagon administration at 45 min (P less than 0.05). Changes in systemic hemodynamic parameters, as well as glucagon and glucose levels were not statistically different between Groups I and II at any time period. Glucagon is a potent mesenteric vasodilator and the resultant profound splanchnic hemodynamic effects are as marked during intravenous administration as during selective SMA infusion.

摘要

本实验旨在确定在犬中通过持续静脉输注(I组,n = 6)与经肠系膜上动脉(SMA)选择性动脉内输注(II组,n = 6)给予等量药理剂量的胰高血糖素(1微克/千克/分钟)是否具有任何血流动力学益处。在基线(BL)以及胰高血糖素输注期间的5、15、30和45分钟测量心输出量、心率、平均动脉压、总外周阻力、肺血管阻力、肠系膜上动脉血流量(SMAQ)、SMA血管阻力和门静脉压力。在I组中,SMAQ在5分钟时几乎翻倍,从基线的570±60毫升/分钟增至1158±146毫升/分钟(P<0.001),在II组中从基线的527±171增至1018±331毫升/分钟(P<0.002)。尽管外周血浆胰高血糖素水平相似,但在30和45分钟时I组的SMAQ显著高于II组(P<0.03)。两组的SMA血管阻力均显著降低,在45分钟静脉给予胰高血糖素期间降低幅度更大(P<0.05)。在任何时间段,I组和II组之间的全身血流动力学参数以及胰高血糖素和葡萄糖水平的变化均无统计学差异。胰高血糖素是一种强效的肠系膜血管扩张剂,静脉给药期间与选择性SMA输注期间产生的显著内脏血流动力学效应一样明显。

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