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人体输注去甲肾上腺素期间肌肉、脂肪组织的血流动力学反应及全身代谢反应。

Haemodynamic responses in muscle and adipose tissue and whole body metabolic responses during norepinephrine infusions in man.

作者信息

Kurpad A, Khan K, Macdonald I, Elia M

机构信息

Dunn Clinical Nutrition Centre, Cambridge, UK.

出版信息

J Auton Nerv Syst. 1995 Aug 4;54(2):163-70. doi: 10.1016/0165-1838(95)00009-m.

Abstract

Circulatory metabolic and cardiovascular responses to 1-h-long infusions of norepinephrine (NE) (approx. 0.2 and 0.4 nmol/kg body weight per min) were measured on two separate occasions in six subjects. The infusions increased circulating NE concentrations 6- and 13-fold, respectively. Blood flow to adipose tissue, measured with the 133Xe clearance technique, increased from a basal value of about 3 ml/100 g per min, to about twice this value at 60 min with both doses of NE. In contrast muscle blood flow was unaffected. The higher dose of NE produced significant increments at 60 min in whole body oxygen consumption (approx. 9%), and circulating concentrations of glucose (approx. 18%), non-esterified fatty acids (approx. 200%) and glycerol (approx. 32%) which were greater than those observed with the low-dose infusion. Changes in blood pressure, pulse and CO2 exchange were observed within 5-10 min after the start of the infusion, whilst changes in adipose tissue blood flow were observed after 15-30 min. It is concluded that in humans (i) a dose of NE as low as 0.2 nmol/kg per min is sufficient to evoke both circulatory and metabolic responses; (ii) the pattern in the adipose tissue blood flow response to NE may help explain some of the conflicting reports about the haemodynamic effects of this hormone in adipose tissue; and (iii) blood flow and vascular resistance in different tissues may be affected in different ways by norepinephrine.

摘要

在六名受试者身上分两次测量了对持续1小时输注去甲肾上腺素(NE)(约0.2和0.4纳摩尔/千克体重每分钟)的循环代谢和心血管反应。输注分别使循环中的NE浓度增加了6倍和13倍。用133Xe清除技术测量的脂肪组织血流量从约3毫升/100克每分钟的基础值增加到60分钟时两种剂量NE下该值的约两倍。相比之下,肌肉血流量未受影响。较高剂量的NE在60分钟时使全身耗氧量(约9%)、循环中的葡萄糖浓度(约18%)、非酯化脂肪酸(约200%)和甘油(约32%)显著增加,且增加幅度大于低剂量输注时观察到的情况。输注开始后5 - 10分钟内观察到血压、脉搏和二氧化碳交换的变化,而脂肪组织血流量的变化在15 - 30分钟后观察到。得出的结论是,在人类中:(i)低至0.2纳摩尔/千克每分钟的NE剂量足以引发循环和代谢反应;(ii)脂肪组织对NE的血流反应模式可能有助于解释关于该激素在脂肪组织中血流动力学效应的一些相互矛盾的报道;(iii)去甲肾上腺素可能以不同方式影响不同组织的血流量和血管阻力。

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