Weisse A B, Moore R J, Zweil P, Regan T J
Am Heart J. 1982 Nov;104(5 Pt 1):968-74. doi: 10.1016/0002-8703(82)90427-6.
In acute myocardial infarction the effect of oxygen administration in modifying infarct size is uncertain. To evaluate this as well as the effects of moderate hypocarbia, four groups of anesthetized dogs were studied experimentally for 2 hours after coronary branch ligation: group I (controls; room air, normal blood gases): group IIA (FIo2 50%, normal Paco2); group IIB (FIo2 50%, low Paco2); and group IIC (50% oxygen given after ligation, normal Paco2). In addition to hemodynamics, the effect of differing blood gas patterns on hemoglobin-oxygen affinity (P50) and ischemic alterations of myocardial electrolyte and water content were evaluated. Hemodynamic changes among the four groups included decreases in LV ejection fraction and cardiac output. The latter was more pronounced in the oxygen treated groups with proportionately greater increases in systemic resistance. P50 increased in all groups, indicating decreased hemoglobin-oxygen affinity; in group IIC this increase was significantly greater than in group I. In all groups an analysis of central and border areas of myocardial ischemia showed loss of potassium and gain of sodium and water, but no beneficial effect on this result by oxygen administration pre or post ligation could be demonstrated. On the contrary, among those dogs administered oxygen the ischemic changes appeared more pronounced than in the control group. Moderate hypocarbia did not modify the myocardial electrolyte and water change. The results of this study do not support the hypothesis that oxygen administration can favorably modify the myocardial changes of ischemia, at least early in the course of myocardial infarction.
在急性心肌梗死中,给予氧气对梗死面积的影响尚不确定。为评估这一影响以及中度低碳酸血症的作用,对四组麻醉犬在冠状动脉分支结扎后进行了2小时的实验研究:第一组(对照组;室内空气,正常血气);第二组A(吸入氧分数50%,正常动脉血二氧化碳分压);第二组B(吸入氧分数50%,低动脉血二氧化碳分压);以及第二组C(结扎后给予50%氧气,正常动脉血二氧化碳分压)。除血流动力学外,还评估了不同血气模式对血红蛋白-氧亲和力(P50)以及心肌电解质和水分含量缺血性改变的影响。四组之间的血流动力学变化包括左心室射血分数和心输出量降低。后者在吸氧治疗组中更为明显,全身阻力相应增加幅度更大。所有组的P50均升高,表明血红蛋白-氧亲和力降低;第二组C中的升高显著大于第一组。对所有组心肌缺血的中心和边缘区域进行分析,均显示钾丢失以及钠和水增加,但未证明结扎前后给予氧气对这一结果有有益影响。相反,在吸氧的犬中,缺血性改变似乎比对照组更明显。中度低碳酸血症未改变心肌电解质和水分变化。本研究结果不支持给予氧气可有利地改善心肌缺血性改变这一假说,至少在心肌梗死病程早期如此。