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迷走神经对急性冠状动脉闭塞时外周循环的抑制作用。

Vagal inhibitory effects on peripheral circulation in acute coronary occlusion.

作者信息

Pelletier C

出版信息

Can J Physiol Pharmacol. 1979 Jun;57(6):547-55. doi: 10.1139/y79-083.

Abstract

The reflex adjustments of the peripheral circulation in response to acute coronary occlusion were studied in anesthetized dogs with isolated vascular beds perfused at constant flow. Coronary occlusion caused significant increases in perfusion pressure which averaged 27 +/- 4 mmHg in the hindlimb, 19 +/- 8 mmHg in skeletal muscle, and 13 + 5 mmHg in the mesenteric artery. These responses were less than half those caused by a similar decrease in aortic pressure obtained with hemorrhage. Coronary occlusion caused no significant changes in renal and paw circulations, while marked vasoconstriction resulted from hemorrhage. When aortic pressure was maintained constant throughout the duration of coronary occlusion, there was a significant vasodilatation in all beds studied. After vagotomy, coronary occlusion caused a constrictor response similar in magnitude to that caused by hemorrhage in each vascular bed and the dilator responses to occlusion at constant aortic pressure were abolished. Both constrictor and dilator changes were prevented by alpha-adrenergic blockade. Mechanical distension of the left ventricle in four dogs with carotid sinus nerves cut caused a significant reflexdilatation in the hindlimb. Thus, coronary occlusion initiates an inhibitory reflex mediated by vagal afferents which opposes peripheral vasoconstriction most effectively in the renal and paw circulations.

摘要

在麻醉的犬身上,利用恒流灌注的离体血管床,研究了外周循环对急性冠状动脉闭塞的反射性调节。冠状动脉闭塞导致灌注压显著升高,后肢平均升高27±4 mmHg,骨骼肌平均升高19±8 mmHg,肠系膜动脉平均升高13±5 mmHg。这些反应不到因出血导致主动脉压类似降低所引起反应的一半。冠状动脉闭塞对肾循环和爪循环无显著影响,而出血则导致明显的血管收缩。在冠状动脉闭塞期间若使主动脉压保持恒定,则在所研究的所有血管床中均出现显著的血管扩张。迷走神经切断术后,冠状动脉闭塞在每个血管床所引起的收缩反应与出血所引起的反应幅度相似,且在主动脉压恒定时对闭塞的扩张反应消失。α-肾上腺素能阻滞可防止收缩和扩张变化。在切断颈动脉窦神经的4只犬中,左心室的机械性扩张引起后肢显著的反射性扩张。因此,冠状动脉闭塞引发一种由迷走神经传入介导的抑制性反射,该反射在肾循环和爪循环中最有效地对抗外周血管收缩。

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