Farrell K J, Witte C L, Witte M H, Mobley W P, Kintner K
Am J Physiol. 1979 Jun;236(6):H846-53. doi: 10.1152/ajpheart.1979.236.6.H846.
The relationships of O2 tension in mesenteric lymph (PmlO2) and mesenteric venous blood (PmvO2) to intestinal O2 delivery/O2 consumption (DO2/VO2) were examined after graded hemorrhage (10 dogs), stepwise increments in FIO2 (4 dogs), and regional infusion of papaverine (2 mg/min or IV glucagon (25 microgram/kg) (4 dogs). Measurements included superior mesenteric arterial flow (SMA-Q), PaO2, PmlO2, and arterial and mesenteric venous blood O2 content (CaO2, CmvO2). Intestinal DO2 was calculated as the product of SMA-Q and CaO2, and VO2 was calculated from the Fick equation [SMA-Q X (CaO2 - CmvO2)]. Graded hemorrhage lowered SMA-Q, DO2 and DO2/VO2 and increased splanchnic O2 extraction (CaO2 - CmvO2). Elevation of FIO2 increased PaO2, PmvO2, and PmlO2. Both PmlO2 and PmvO2 varied directly with DO2/VO2 and PaO2, but PmlO2 showed greater sensitivity to PaO2. Papaverine and glucagon both increased SMA-Q, DO2, CmvO2, and PmvO2, BUT PmlO2 rose after papaverine, indicating greater capillary perfusion, and fell after glucagon, suggesting diversion of mesenteric blood flow through arteriovenous shunts. Thus, either PmvO2 or PmlO2 is ordinarily an accurate measure of intestinal tissue oxygenation, but the disparate response after glucagon suggests that PmlO2 is a more reliable indicator.
在分级出血(10只犬)、逐步增加吸入氧分数(FIO2)(4只犬)以及局部输注罂粟碱(2mg/min)或静脉注射胰高血糖素(25μg/kg)(4只犬)后,研究了肠系膜淋巴中的氧分压(PmlO2)和肠系膜静脉血中的氧分压(PmvO2)与肠道氧输送/氧消耗(DO2/VO2)之间的关系。测量指标包括肠系膜上动脉血流量(SMA-Q)、动脉血氧分压(PaO2)、PmlO2以及动脉血和肠系膜静脉血的氧含量(CaO2、CmvO2)。肠道DO2通过SMA-Q与CaO2的乘积计算得出,VO2根据Fick方程[SMA-Q×(CaO2 - CmvO2)]计算得出。分级出血降低了SMA-Q、DO2和DO2/VO2,并增加了内脏氧摄取(CaO2 - CmvO2)。提高FIO2可增加PaO2、PmvO2和PmlO2。PmlO2和PmvO2均与DO2/VO2和PaO2呈直接相关,但PmlO2对PaO2更为敏感。罂粟碱和胰高血糖素均增加了SMA-Q、DO2、CmvO2和PmvO2,但罂粟碱注射后PmlO2升高,表明毛细血管灌注增加,而胰高血糖素注射后PmlO2降低,提示肠系膜血流通过动静脉分流。因此,通常情况下,PmvO2或PmlO2均可准确反映肠道组织的氧合情况,但胰高血糖素注射后的不同反应表明PmlO2是更可靠的指标。