Chernow B, Lake C R, Barton M, Chobanian S, Zaloga G P, Casey L C, Fletcher J R
J Trauma. 1984 Mar;24(3):229-32. doi: 10.1097/00005373-198403000-00008.
The endogenous catecholamine response to hemorrhagic hypotension is poorly defined since most data have been derived from experiments in lower animal species. To clarify this situation we studied the plasma norepinephrine (NE) and epinephrine (Epi) responses to hemorrhagic hypotension in ten healthy male baboons (Papio anubis). After an overnight fast, animals were tranquilized with 100 mg of ketamine hydrochloride after which femoral artery and vein catheters were inserted. The animals then underwent phlebotomy of 20 ml/kg over 60 minutes with retransfusion of the autologous blood over the next 30 minutes. Plasma specimens for catecholamines were collected at 5, 15, 30, and 60 minutes during phlebotomy and again at 15 and 30 minutes during retransfusion. Plasma NE and Epi concentrations were measured by a radioenzymatic technique. Mean arterial blood pressure (MAP) decreased (p less than 0.01) and heart rate (HR) increased (p less than 0.01) within 15 minutes of phlebotomy, and these variables returned to baseline with retransfusion. Plasma NE and Epi levels increased (p less than 0.025) within 5 minutes of the onset of 'hemorrhage' and within 15 minutes plasma NE concentrations were 56% above baseline, whereas plasma Epi levels were six times greater than baseline. With retransfusion, plasma NE and Epi levels returned to baseline concentrations. We conclude: 1) in a primate species, the sympathetic nervous system responds rapidly to hemorrhage; 2) contrary to prior studies in rats, plasma NE increases as rapidly as Epi but not to the same degree; 3) plasma NE and Epi concentrations rapidly return to baseline levels with fluid resuscitation; and 4) there is little justification for the use of exogenous synthetic catecholamines in hemorrhagic hypotension where fluid resuscitation remains the treatment of choice.
由于大多数数据来自对低等动物物种的实验，内源性儿茶酚胺对出血性低血压的反应尚不明确。为了澄清这种情况，我们研究了10只健康雄性狒狒（埃及狒狒）对出血性低血压的血浆去甲肾上腺素（NE）和肾上腺素（Epi）反应。禁食过夜后，给动物注射100毫克盐酸氯胺酮使其镇静，然后插入股动脉和静脉导管。然后，动物在60分钟内进行20毫升/千克的放血，并在接下来的30分钟内回输自体血。在放血期间的5、15、30和60分钟以及回输期间的15和30分钟采集儿茶酚胺血浆标本。采用放射酶法测定血浆NE和Epi浓度。放血后15分钟内平均动脉血压（MAP）下降（p<0.01），心率（HR）升高（p<0.01），回输后这些变量恢复到基线水平。“出血”开始后5分钟内血浆NE和Epi水平升高（p<0.025），15分钟内血浆NE浓度比基线高56%，而血浆Epi水平比基线高6倍。回输后，血浆NE和Epi水平恢复到基线浓度。我们得出结论：1）在灵长类动物中，交感神经系统对出血反应迅速；2）与先前对大鼠的研究相反，血浆NE与Epi一样迅速升高，但程度不同；3）液体复苏后血浆NE和Epi浓度迅速恢复到基线水平；4）在液体复苏仍是首选治疗方法的出血性低血压中，使用外源性合成儿茶酚胺几乎没有依据。
