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低血容量性低血压和休克期间离体隐动脉段的肾上腺素能反应性。

Adrenergic responsiveness of isolated saphenous arterial segments during hypovolemic hypotension and shock.

作者信息

Bond R F, Bond C H, Peissner L C, Manning E S

出版信息

Circ Shock. 1981;8(3):323-33.

PMID:7249261
Abstract

Previous studies from this laboratory suggest that cutaneous vasculature responds to hypovolemic hypotension by constriction as a direct result of catecholamine interaction with alpha-receptors (A.J.P. 212:488, 1967; A.J.P. 219:1210, 1970). The objectives of the present study were to determine if the effective smooth muscle population or adrenergic innervation densities varied as the dog progressively moves from reversible to irreversible hemorrhagic shock. Saphenous arteries were removed with adventitia intact during various stages of shock and placed in an isolated tissue chamber filled with warm (37 degrees C) Krebs-Henseleit solution bubbled with 95% O2 and 5% CO2. Norepinephrine (NE) dose-response curves and periarterial electrical stimulation (ES) response studies were conducted. The maximum responses to NE which we consider to represent an index of effective physiological smooth muscle population and ES (ie, effective physiological innervation density) decreased slightly during the progression from control Stage I to Stage III shock. The sensitivity of the innervated alpha-receptors as measured by the ES necessary to obtain a 50% maximal response (ES50) did not change during any stage of shock, indicating normal neural function. However, a significant reduction in NE ED50 from a control of 1.9 +/- 0.3 microM to 1.2 +/- 0.1 microM during early compensatory shock which persisted through early normovolemic shock indicated augmentation of alpha-receptor sensitivity. Signs of alpha-receptor desensitivation did not appear until late in the irreversible shock process when the NE ED50 increased to 3.9 +/- 1.1 microM.

摘要

本实验室之前的研究表明,皮肤血管系统会因儿茶酚胺与α受体相互作用而直接收缩,从而对低血容量性低血压作出反应(《美国生理学杂志》212:488,1967;《美国生理学杂志》219:1210,1970)。本研究的目的是确定随着犬从可逆性出血性休克逐渐发展为不可逆性出血性休克,有效的平滑肌数量或肾上腺素能神经支配密度是否会发生变化。在休克的各个阶段,将带有完整外膜的隐动脉取出,置于一个充满温暖(37摄氏度)、用95%氧气和5%二氧化碳鼓泡的克雷布斯-亨塞尔特溶液的离体组织浴槽中。进行了去甲肾上腺素(NE)剂量-反应曲线和动脉周围电刺激(ES)反应研究。我们认为对NE的最大反应代表有效生理平滑肌数量的指标,而ES(即有效生理神经支配密度)在从对照的I期到III期休克的进展过程中略有下降。通过获得50%最大反应所需的ES来衡量的神经支配α受体的敏感性在休克的任何阶段都没有变化,表明神经功能正常。然而,在早期代偿性休克期间,NE的ED50从对照的1.9±0.3微摩尔显著降至1.2±0.1微摩尔,并持续到早期血容量正常休克,这表明α受体敏感性增强。直到不可逆性休克后期NE的ED50增加到3.9±1.1微摩尔时,才出现α受体脱敏的迹象。

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