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犬类肺血管系统中的临界闭合

Critical closure in the canine pulmonary vasculature.

作者信息

Graham R, Skoog C, Oppenheimer L, Rabson J, Goldberg H S

出版信息

Circ Res. 1982 Apr;50(4):566-72. doi: 10.1161/01.res.50.4.566.

Abstract

The vascular pressure-flow (P-Q) relationships in zone II (West et al.) were studied in isolated canine left lower lobes, in order to characterize the total resistance in the pulmonary vascular bed with respect to incremental or flow resistance and critical closure. At each of five levels of static lung inflation, the P-Q relationship was curvilinear at low flow and rectilinear at higher flows. The slope of the linear portion was not significantly different at alveolar pressures (PA) = 5, 7, or 9 cm H2O, but decreased significantly at PA = 11 and 15 cm H2O ((P less than 0.05), indicating an increase in flow resistance. The pulmonary artery pressure (Ppa) fell to the same value at zero flow regardless of inflation level [10.1 +/- 1.0 (SD) cm H2O at PA = 5 cm H2O to 10.9 +/- 2.7 (SD) at PA = 15 cm H2O]. The Ppa intercept (Ppai), extrapolated from the linear portion of the P-Q curve and representing the average closing pressure for the vascular bed, increased from 16.0 +/- 1.8 (SD) cm H2O at PA = 5.0 to 26.5 +/- 4.4 (SD) cm H2O at PA = 15 (P less than 0.05) in a direct one-to-one relationship with the increase in PA. Since this results in a constant transmural gradient at the alveolar vessel level, these vessels must be the major fraction which undergo critical closure. Operationally defined vascular compliance, determined from the slope of a simultaneously obtained pressure-volume (P-V) curve, decreased significantly from 1.51 +/- 0.62 (SD) ml/cm H2O at PA = 5.0 H2O to 0.87 +/- 0.27 ml/cm H2O at PA = 15 cm H2O (P less than 0.05).

摘要

为了描述肺血管床相对于增量或血流阻力以及临界闭合的总阻力,在离体犬左下叶研究了第二区(韦斯特等人)的血管压力-流量(P-Q)关系。在五个静态肺膨胀水平中的每一个水平下,P-Q关系在低流量时呈曲线,在高流量时呈直线。在肺泡压(PA)=5、7或9 cmH₂O时,线性部分的斜率无显著差异,但在PA = 11和15 cmH₂O时显著降低(P<0.05),表明血流阻力增加。无论膨胀水平如何,零流量时肺动脉压(Ppa)都降至相同值[PA = 5 cmH₂O时为10.1±1.0(标准差)cmH₂O,PA = 15 cmH₂O时为10.9±2.7(标准差)]。从P-Q曲线的线性部分外推得出的Ppa截距(Ppai),代表血管床的平均闭合压,从PA = 5.0时的16.0±1.8(标准差)cmH₂O增加到PA = 15时的26.5±4.4(标准差)cmH₂O(P<0.05),与PA的增加呈直接的一对一关系。由于这导致肺泡血管水平的跨壁梯度恒定,这些血管必定是发生临界闭合的主要部分。根据同时获得的压力-容积(P-V)曲线的斜率确定的可操作定义的血管顺应性,从PA = 5.0H₂O时的1.51±0.62(标准差)ml/cmH₂O显著降低到PA = 15 cmH₂O时的0.87±0.27 ml/cmH₂O(P<0.05)。

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