Binah O, Bomzon A, Blendis L M, Mordohovich D, Better O S
Clin Sci (Lond). 1985 Dec;69(6):647-53. doi: 10.1042/cs0690647.
Patients with obstructive jaundice are susceptible to postoperative shock. To clarify the mechanism of this phenomenon, we compared the contractile response to isoprenaline of isolated ventricular preparations from three groups of dogs: (a) dogs with chronic bile-duct ligation (CBDL), (b) dogs with choledochocaval anastomosis (CDCA) and (c) sham-operated dogs (SO). Isolated ventricular muscles from CBDL and CDCA dogs showed a depressed contractile response to isoprenaline as compared with SO dogs. Mechanical performance was spared in the CBDL and CDCA dogs. There were no differences in the contractile responses of SO and CBDL dogs, either to ouabain or to changes in the rates of stimulation (force-frequency relationships). These data demonstrate that, in the dog, obstructive jaundice and/or cholaemia are associated with blunted contractile response to beta-adrenoreceptor stimulation in the face of intact basic mechanical performance. Similar inotropic refractoriness to beta-adrenoreceptor stimulation could contribute to the susceptibility to postoperative shock in patients with obstructive jaundice.
梗阻性黄疸患者术后易发生休克。为阐明这一现象的机制，我们比较了三组犬离体心室标本对异丙肾上腺素的收缩反应：(a) 慢性胆管结扎（CBDL）犬；(b) 胆总管腔静脉吻合术（CDCA）犬；(c) 假手术犬（SO）。与SO犬相比，CBDL犬和CDCA犬的离体心室肌对异丙肾上腺素的收缩反应减弱。CBDL犬和CDCA犬的机械性能未受影响。SO犬和CBDL犬对哇巴因或刺激频率变化（力-频率关系）的收缩反应无差异。这些数据表明，在犬中，梗阻性黄疸和/或胆血症与在基本机械性能完好的情况下对β-肾上腺素能受体刺激的收缩反应减弱有关。对β-肾上腺素能受体刺激的类似变力性不应性可能导致梗阻性黄疸患者术后易发生休克。
