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出血性低血压时下丘脑的局部血流

Local blood flow of the hypothalamus in haemorrhagic hypotension.

作者信息

Nyáry I, Maklári E, Kovách A G, Harka I

出版信息

Acta Physiol Acad Sci Hung. 1977;49(1):45-56.

PMID:755332
Abstract

Local blood flow of the hypothalamus (HBF) was measured by the hydrogen clearance method in anaesthetized dogs. The average value for HBF in normal controls was 0.64 +/- 0.05 ml/g/min, which compares favourably with values available in the literature. During haemorrhagic hypotension induced by a modified Wiggers method there occurred a marked reduction of HBF to 52% of the initial control value at a mean arterial blood pressure (MABP) of 55--60 mm Hg and to 44% at 35--40 mm Hg. Prevention of concomitant extracellular acidosis by infusion of sodium bicarbonate solution during the hypotensive period resulted in a significantly smaller decrease in HBF as compared to an untreated control group, and a significant protection of HBF was also found at 55--60 mm Hg MABP in the bicarbonate treated group, but not in controls treated with physiologic saline. Hypothalamic tissue hypoxia was inevitable in untreated bled animals due to insufficient circulatory transport, while evidence suggested that the metabolism might have remained unaltered in the group protected against acidosis during haemorrhage. Analysis of the control of local hypothalamic blood flow revealed a significant correlation (r = 0.7026, p less than 0.001) between HBF and arterial blood pH in severe hypotension which is outside the autoregulatory blood pressure domain.

摘要

采用氢清除法在麻醉犬身上测量下丘脑局部血流量(HBF)。正常对照组HBF的平均值为0.64±0.05毫升/克/分钟,与文献中的值相比情况良好。在采用改良维格斯法诱导出血性低血压期间,当平均动脉血压(MABP)为55 - 60毫米汞柱时,HBF显著降低至初始对照值的52%,当MABP为35 - 40毫米汞柱时降至44%。在低血压期间输注碳酸氢钠溶液预防伴随的细胞外酸中毒,与未治疗的对照组相比,HBF的降低显著较小,并且在碳酸氢钠治疗组中,当MABP为55 - 60毫米汞柱时,HBF得到了显著保护,而生理盐水治疗的对照组则没有。由于循环运输不足,未治疗的失血动物中下丘脑组织缺氧不可避免,而有证据表明,在出血期间预防酸中毒的组中,代谢可能保持不变。对下丘脑局部血流控制的分析显示,在严重低血压(超出自动调节血压范围)时,HBF与动脉血pH之间存在显著相关性(r = 0.7026,p < 0.001)。

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