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血液酸碱度和动脉血二氧化碳分压作为心肌血流控制中的化学因素。

Blood pH and PaCO2 as chemical factors in myocardial blood flow control.

作者信息

Tarnow J, Brückner J B, Eberlein H J, Gethmann J W, Hess W, Patschke D, Wilde J

出版信息

Basic Res Cardiol. 1975 Nov-Dec;70(6):685-96. doi: 10.1007/BF01906477.

Abstract

The effect of metabolic and hypercapnic acidosis on myocardial blood flow was studied during intravenous infusions of hydrochloric acid solutions (n = 12) and during passive ventilation with 5% CO2 (n = 5) in anaesthetized, closed chest dogs. Below a pH of 7.2 metabolic acidosis at normal arterial CO2-tensions caused an increase of coronary blood flow and a decrease of coronary vascular resistance associated with a narrowed myocardial arteriovenous O2-difference, indicating vasodilation at unchanged myocardial oxygen consumption. In propranolol-pretreated dogs myocardial blood flow and coronary oxygen AV difference remained unaffected, suggesting that the coronary dilatory effect of metabolic acidemia involves beta adrenergic stimulation. Coronary vasodilation induced by increasing arterial pCO2 was found to the significantly greater as compared with the dilatory effect of metabolic acidosis at the same blood pH level. Blocking of beta receptors did not reduce the coronary response to increased arterial CO2-tensions. It is concluded that the coronary vasodilation observed during hypercapnic acidosis is neither mediated by a beta adrenergic stimulation nor dependent of the concomitant change in blood pH. The possible sites of the coronary dilatory actions of increased arterial CO2-tensions are discussed.

摘要

在麻醉的闭胸犬中,通过静脉输注盐酸溶液(n = 12)以及用5%二氧化碳进行被动通气(n = 5),研究了代谢性酸中毒和高碳酸性酸中毒对心肌血流的影响。在正常动脉二氧化碳分压下,pH低于7.2的代谢性酸中毒会导致冠状动脉血流增加和冠状动脉血管阻力降低,同时心肌动静脉氧差缩小,这表明在心肌氧耗不变的情况下出现了血管舒张。在普萘洛尔预处理的犬中,心肌血流和冠状动脉氧动静脉差未受影响,这表明代谢性酸血症的冠状动脉舒张作用涉及β肾上腺素能刺激。与相同血pH水平下代谢性酸中毒的舒张作用相比,发现动脉pCO₂升高引起的冠状动脉舒张作用明显更强。阻断β受体并未降低冠状动脉对动脉二氧化碳分压升高的反应。得出的结论是,高碳酸性酸中毒期间观察到的冠状动脉舒张既不是由β肾上腺素能刺激介导的,也不依赖于血pH的伴随变化。讨论了动脉二氧化碳分压升高的冠状动脉舒张作用的可能部位。

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