McPherson R W, Koehler R C, Traystman R J
Department of Anesthesiology/Critical Care Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287.
Am J Physiol. 1994 Feb;266(2 Pt 2):H476-82. doi: 10.1152/ajpheart.1994.266.2.H476.
We tested the hypothesis that NO synthase inhibition with N omega-nitro-L-arginine methyl ester (L-NAME) and alpha 2-adrenoreceptor stimulation with dexmedetomidine (Dex) decreases the cerebral blood flow (CBF) response to hypoxia. In isoflurane-anesthetized dogs, CBF was measured during two episodes of hypoxic hypoxia. In a control group (n = 6), CBF increased similarly from 83 +/- 4 to 210 +/- 30 ml.min-1 x 100 g-1 and from 88 +/- 7 to 205 +/- 27 (+/- SE) ml.min-1 x 100 g-1 during two hypoxic episodes. In a second group (n = 6), hypoxia increased CBF from 88 +/- 15 to 204 +/- 38 ml.min-1 x 100 g-1. Dex (10 micrograms/kg i.v.) reduced normoxic CBF to 54 +/- 8 ml.min-1 x 100 g-1, and subsequent hypoxia increased CBF to 97 +/- 14 ml.min-1 x 100 g-1. In a third group pretreated with L-NAME (40 mg/kg i.v.) 1 h before anesthesia (n = 6), normoxic CBF was less than in the control group (52 +/- 2 vs. 83 +/- 4 ml.min-1 x 100 g-1). Hypoxia increased CBF to 177 +/- 13 ml.min-1 x 100 g-1. Dex after L-NAME further decreased normoxic CBF to 37 +/- 3 ml.min-1 x 100 g-1, and subsequent hypoxia increased CBF to 106 +/- 18 ml.min-1 x 100 g-1. Dex, L-NAME, and Dex + L-NAME each reduced cerebral O2 transport (CBF x arterial O2 content) during normoxia, but the increase in CBF during hypoxia was sufficient to prevent further decreases in O2 transport. Thus the response to hypoxia remained proportional to normoxic levels of CBF.(ABSTRACT TRUNCATED AT 250 WORDS)
用Nω-硝基-L-精氨酸甲酯(L-NAME)抑制一氧化氮合酶以及用右美托咪定(Dex)刺激α2-肾上腺素能受体会降低大脑对缺氧的血流(CBF)反应。在异氟烷麻醉的犬中,在两次低氧性缺氧发作期间测量CBF。在对照组(n = 6)中,在两次缺氧发作期间,CBF同样从83±4增加到210±30 ml·min-1×100 g-1,以及从88±7增加到205±27(±SE)ml·min-1×100 g-1。在第二组(n = 6)中,缺氧使CBF从88±15增加到204±38 ml·min-1×100 g-1。Dex(10微克/千克静脉注射)将常氧CBF降低至54±8 ml·min-1×100 g-1,随后的缺氧使CBF增加至97±14 ml·min-1×100 g-1。在麻醉前1小时用L-NAME(40毫克/千克静脉注射)预处理的第三组(n = 6)中,常氧CBF低于对照组(52±2对83±4 ml·min-1×100 g-1)。缺氧使CBF增加至177±13 ml·min-1×100 g-1。L-NAME后给予Dex进一步将常氧CBF降低至37±3 ml·min-1×100 g-1,随后的缺氧使CBF增加至106±18 ml·min-1×100 g-1。Dex、L-NAME和Dex + L-NAME在常氧期间均降低了脑氧输送(CBF×动脉血氧含量),但缺氧期间CBF的增加足以防止氧输送进一步降低。因此,对缺氧的反应仍与常氧水平的CBF成比例。(摘要截短至250字)