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犬静脉输注硝酸甘油单独及与多巴胺联合应用时的脑血流量和颅内压

Cerebral blood flow and intracranial pressure in the dog during intravenous infusion of nitroglycerin alone and in combination with dopamine.

作者信息

von Essen C, Kistler J P, Lees R S, Zervas N T

出版信息

Stroke. 1981 May-Jun;12(3):331-8. doi: 10.1161/01.str.12.3.331.

Abstract

Nitroglycerin, long known as a safe and effective dilator of the large coronary arteries, has recently been shown to dilate the basilar artery of the dog after experimentally induced vasospasm. In this study we have evaluated the effects of intravenous nitroglycerin on local cerebral blood flow (H2 clearance technique) and intracranial pressure (intracisternal needle monitor) in normal beagle dogs (Group 1). In each of 7 dogs, infusion of nitroglycerin at rates of 3, 5, and 10 microgram/kg/min did not change blood flow in the right and left caudate nucleus, thalamus, frontal and parietal cortex. Autoregulation of cerebral blood flow remained unimpaired and intracranial pressure remained stable during nitroglycerin infusion. The effects of a combination of intravenous nitroglycerin and dopamine on local cerebral blood flow was evaluated in another group of normal beagle dogs (Group 2). Local cerebral blood flow decreased or remained unchanged in response to intravenous infusion of dopamine at low rates, increased in response to moderate rates and again decreased in response to high infusion rates. These dopamine induced changes in blood flow occurred whether or not nitroglycerin was infused simultaneously. When the vasoconstrictor activity of dopamine was blocked by phentolamine or methysergide, local cerebral blood flow increased at moderate and high infusion rates, again whether or not nitroglycerin was infused simultaneously. Our data suggest that nitroglycerin affects mainly the extracerebral capacitance arteries while dopamine affects the smaller intraparenchymal resistance vessels. Nitroglycerin has little effect on cerebral blood flow even when used in combination with dopamine.

摘要

硝酸甘油长期以来一直被认为是一种安全有效的大冠状动脉扩张剂,最近的研究表明,在实验性诱导血管痉挛后,它能扩张犬的基底动脉。在本研究中,我们评估了静脉注射硝酸甘油对正常比格犬(第1组)局部脑血流量(H2清除技术)和颅内压(脑池内针监测)的影响。在7只犬中,以3、5和10微克/千克/分钟的速率输注硝酸甘油,并未改变左右尾状核、丘脑、额叶和顶叶皮质的血流量。在输注硝酸甘油期间,脑血流量的自动调节未受损害,颅内压保持稳定。在另一组正常比格犬(第2组)中,评估了静脉注射硝酸甘油和多巴胺联合使用对局部脑血流量的影响。静脉输注低剂量多巴胺时,局部脑血流量减少或保持不变,输注中等剂量时增加,输注高剂量时再次减少。无论是否同时输注硝酸甘油,多巴胺都会引起这些血流变化。当多巴胺的血管收缩活性被酚妥拉明或麦角新碱阻断时,无论是否同时输注硝酸甘油,在中等和高输注速率下局部脑血流量都会增加。我们的数据表明,硝酸甘油主要影响脑外容量动脉,而多巴胺影响较小的脑实质内阻力血管。即使与多巴胺联合使用,硝酸甘油对脑血流量的影响也很小。

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