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酸中毒在缺血期间早期收缩功能障碍中的作用:来自pHo测量的证据。

Role of acidosis in early contractile dysfunction during ischemia: evidence from pHo measurements.

作者信息

Weiss J, Couper G S, Hiltbrand B, Shine K I

出版信息

Am J Physiol. 1984 Nov;247(5 Pt 2):H760-7. doi: 10.1152/ajpheart.1984.247.5.H760.

DOI:10.1152/ajpheart.1984.247.5.H760
PMID:6496757
Abstract

To investigate the contribution of acidosis to contractile dysfunction during early myocardial ischemia, miniature intramyocardial pH electrodes (0.2 mm tip diam) were used to correlate changes in extracellular pH (pHo) with tension in the isolated arterially perfused rabbit interventricular septum. A number of findings argue against acidosis as the major cause of contractile failure during early ischemia. During hypoxia without glucose present, the rate and pattern of tension decline was very similar to total ischemia, suggesting that a common mechanism is involved. Throughout the initial period in which tension declined by 50%, however, pHo increased in the six of eight preparations during hypoxia without glucose. During hypoxia with glucose present, tension fell less rapidly than during hypoxia without glucose despite a significantly greater fall in pHo in the former case. The maximal rate of relaxation (-dT/dt) was markedly more sensitive to ischemia, hypoxia, or exposure to inhibitors of aerobic metabolism (2,4-dinitrophenol and Na azide) than the maximal rate of force development (+dT/dt). In contrast, +dT/dt and -dT/dt decreased almost symmetrically during exposure to respiratory acidosis. During ischemia, the change in pHo associated with 50% reduction in tension was 0.11 +/- 0.04 units. During respiratory acidosis, this value was 0.45 +/- 0.02 units. From these observations we concluded that acidosis is unlikely to be a major factor in the early decline of tension during ischemia.

摘要

为研究酸中毒在心肌缺血早期对收缩功能障碍的影响,采用微型心肌内pH电极(尖端直径0.2mm),将离体兔室间隔在动脉灌注下的细胞外pH(pHo)变化与张力变化进行关联。多项研究结果表明,酸中毒不太可能是缺血早期收缩功能衰竭的主要原因。在无葡萄糖存在的缺氧状态下,张力下降的速率和模式与完全缺血非常相似,提示存在共同机制。然而,在张力下降50%的初始阶段,八份标本中有六份在无葡萄糖的缺氧状态下pHo升高。在有葡萄糖存在的缺氧状态下,尽管pHo下降幅度明显更大,但张力下降速度比无葡萄糖的缺氧状态下慢。最大舒张速率(-dT/dt)对缺血、缺氧或暴露于有氧代谢抑制剂(2,4-二硝基苯酚和叠氮化钠)的敏感性明显高于最大张力发展速率(+dT/dt)。相反,在呼吸性酸中毒期间,+dT/dt和 -dT/dt几乎对称下降。在缺血期间,张力降低50%时pHo的变化为0.11±0.04单位。在呼吸性酸中毒期间,该值为0.45±0.02单位。基于这些观察结果,我们得出结论,酸中毒不太可能是缺血早期张力下降的主要因素。

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