Michel R P, Hakim T S, Chang H K
J Appl Physiol Respir Environ Exerc Physiol. 1984 Aug;57(2):309-14. doi: 10.1152/jappl.1984.57.2.309.
To further subdivide the pressure drops across the arterial, middle, and venous segments obtained from the occlusion technique, we compared the pressures at the distal end of the arterial segment (Pa') and the proximal end of the venous segment (Pv') measured with this technique, with the pressures measured with 1.2-mm catheters in a small artery (Psa) and a small vein (Psv) of left lower lobes of dogs perfused in situ. The arterial (Pa) and venous (Pv) pressures were monitored and blood flow kept constant. Under control conditions the mean Pa, Psa, Pa', Pv', Psv, and Pv were 18.1, 13.0, 11.3, 9.2, 8.4, and 0.7 mmHg, respectively, suggesting that 29 and 44% of the total pulmonary vascular resistance (PVR) were in arteries and veins with diameters larger than at least 1.2 mm. Serotonin and histamine increased the pressure drops in arteries and veins, respectively, both larger and smaller than 1.2 mm. The small catheter pressures increased with flow rate. Microvascular pressures calculated from occlusion and small catheter measurements were higher than those calculated from the formula assuming 40% of PVR on the venous side. Our data suggest that a substantial proportion of resistance in the lung may lie in larger arteries and veins, the fraction of resistance in vessels under 1.2 mm increases with vasoconstrictors, the arterial and venous segments include muscular vessels under 1.2 mm, and calculation of microvascular pressures assuming 40% of the resistance in the veins may be misleading, especially when vasomotor tone is increased.
为了进一步细分通过阻塞技术获得的动脉段、中间段和静脉段的压力降,我们将用该技术测量的动脉段远端压力(Pa')和静脉段近端压力(Pv'),与在原位灌注的犬左下叶小动脉(Psa)和小静脉(Psv)中用1.2毫米导管测量的压力进行了比较。监测动脉压(Pa)和静脉压(Pv)并保持血流恒定。在对照条件下,平均Pa、Psa、Pa'、Pv'、Psv和Pv分别为18.1、13.0、11.3、9.2、8.4和0.7 mmHg,这表明总肺血管阻力(PVR)的29%和44%分别存在于直径至少大于1.2毫米的动脉和静脉中。5-羟色胺和组胺分别增加了直径大于和小于1.2毫米的动脉和静脉中的压力降。小导管压力随流速增加。根据阻塞和小导管测量计算出的微血管压力高于根据假设静脉侧PVR为40%的公式计算出的压力。我们的数据表明,肺中相当一部分阻力可能存在于较大的动脉和静脉中,直径小于1.2毫米的血管中的阻力比例会随着血管收缩剂的作用而增加,动脉段和静脉段包括直径小于1.2毫米的肌性血管,并且假设静脉中40%阻力来计算微血管压力可能会产生误导,尤其是在血管运动张力增加时。