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实验性冠状动脉闭塞后通过吸氧增加缺血心肌的侧支血流。

Augmentation of collateral blood flow to the ischaemic myocardium by oxygen inhalation following experimental coronary artery occlusion.

作者信息

Ribeiro L G, Louie E K, Davis M A, Maroko P R

出版信息

Cardiovasc Res. 1979 Mar;13(3):160-6. doi: 10.1093/cvr/13.3.160.

Abstract

Since the mechanism by which oxygen reduces infarct size is not yet completely understood, we tested the hypothesis that breathing 100% oxygen may alter regional myocardial blood flow. In 23 anaesthetised open-chest dogs with acute occlusions of the left anterior descending coronary artery or of its apical branch, regional myocardial blood flow was determined by the microsphere technique at 15 and 30 min following coronary artery occlusion. Fifteen treated dogs were ventilated with 100% oxygen beginning 17 min after occlusion (ie, after the first determination of regional myocardial blood flow) and continuing until the end of the experiment, while the other 8 dogs served as controls and were ventilated continuously with room air. In treated dogs, following the administration of 100% oxygen, transmural flow at sites remote from the distribution of the occluded vessel (nonischaemic sites) decreased from 121 +/- 5 before oxygen to 108 +/- 6 cm3 . min-1 . 100g-1 (P less than 0.05). However, in the ischaemic sites it increased from 28 +/- 3 before oxygen to 32 +/- 3 cm3 . min-1 . 100g-1 (P less than 0.05). In the control dogs transmural flow, 15 and 30 min after occlusion, was, in nonischaemic sites, 118 +/- 7 and 125 +/- 10 cm3 . min-1 . 100g-1 NS, and in the ischaemic sites 27 +/- 4 and 25 +/- 3 cm3 . min-1 . 100g-1 NS, respectively. Thus, ventilation with 100% oxygen can augment perfusion of the ischaemic myocardium and this may be, in part, the mechanism by which it reduces infarct size.

摘要

由于氧气减小梗死面积的机制尚未完全明确,我们检验了如下假设:吸入100%氧气可能会改变局部心肌血流。对23只左前降支冠状动脉或其心尖分支急性闭塞的开胸麻醉犬,在冠状动脉闭塞后15分钟和30分钟,采用微球技术测定局部心肌血流。15只接受治疗的犬在闭塞17分钟后(即首次测定局部心肌血流后)开始用100%氧气通气,持续至实验结束,而另外8只犬作为对照,持续用室内空气通气。在接受治疗的犬中,给予100%氧气后,远离闭塞血管分布部位(非缺血部位)的透壁血流从吸氧前的121±5降至108±6 cm³·min⁻¹·100g⁻¹(P<0.05)。然而,在缺血部位,血流从吸氧前的28±3增至32±3 cm³·min⁻¹·100g⁻¹(P<0.05)。在对照犬中,闭塞后15分钟和30分钟时,非缺血部位的透壁血流分别为118±7和125±10 cm³·min⁻¹·100g⁻¹(无显著性差异),缺血部位分别为27±4和25±3 cm³·min⁻¹·100g⁻¹(无显著性差异)。因此,100%氧气通气可增加缺血心肌的灌注,这可能是其减小梗死面积的部分机制。

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