Aharinejad S, Schraufnagel D E, Miksovsky A, Larson E K, Marks S C
Department of Cell Biology, University of Massachusetts, Medical Center, Worcester, USA.
J Thorac Cardiovasc Surg. 1995 Jul;110(1):148-56. doi: 10.1016/s0022-5223(05)80020-0.
Serum endothelin levels increase during sepsis, ischemia, reperfusion, pulmonary operations, and systemic hypertension after surgery. Despite extensive study, the site and extent of action of endothelin on the pulmonary microcirculation are not well established. To assess the effect of endothelin on the pulmonary vasculature, especially the veins, the circulation of the lung was cast with methyl methacrylate 10 minutes after endothelin-1 was given intravenously to rats. Endothelin-1, at concentrations of 0.1, 1.0, and 10.0 micrograms/kg of body weight, increased the mean systemic arterial blood pressure 8%, 7%, and 17% (p < 0.01) and mean pulmonary arterial blood pressure 15%, 28%, and 53%, respectively (p < 0.01). The proportional increases in the pulmonary pressures were greater than those of the systemic pressures (p < 0.01). Scanning electron microscopy of cast blood vessels showed more contraction of the veins than the arteries. For doses of 0, 0.1, 1.0, and 10.0 micrograms/kg, the respective focal contraction of small veins was 6.7% (+/- 4.4), 15.4% (+/- 9.1), 23.3% (+/- 10.1), and 14.4% (+/- 9.0) of the vessel diameter (p < 0.01). In addition, the diameter of capillaries increased (p < 0.01) and the capillary interspaces decreased (p < 0.01) after endothelin administration, but not in a linear dose-dependent manner. The dose of endothelin correlated with the change in the mean systemic (r = 0.82, p < 0.01) and the mean pulmonary (r = 0.80, p < 0.01) blood pressures. The mean pulmonary pressure change correlated with the focal venous contraction on the casts (r = 0.35, p < 0.01), capillary diameter (r = 0.64, p < 0.01), and capillary interspace distance (r = -0.34, p < 0.01). The venous contraction was related to the capillary diameter (r = 0.26, p < 0.01). The most notable effect of endothelin-1 in rat pulmonary microcirculation is focal constriction of small veins. Because this effect may lead to pulmonary edema, endothelin antagonists may be of benefit in a variety of clinical situations.
脓毒症、局部缺血、再灌注、肺部手术及术后全身性高血压期间,血清内皮素水平会升高。尽管进行了广泛研究,但内皮素在肺微循环中的作用部位和程度仍未完全明确。为评估内皮素对肺血管系统,尤其是静脉的影响,给大鼠静脉注射内皮素-1 10分钟后,用甲基丙烯酸甲酯灌注肺循环。内皮素-1剂量分别为0.1、1.0和10.0微克/千克体重时,平均体动脉血压分别升高8%、7%和17%(p<0.01),平均肺动脉血压分别升高15%、28%和53%(p<0.01)。肺动脉压力的升高比例大于体循环压力(p<0.01)。铸型血管的扫描电子显微镜检查显示,静脉的收缩比动脉更明显。对于0、0.1、1.0和10.0微克/千克的剂量,小静脉的局部收缩分别为血管直径的6.7%(±4.4)、15.4%(±9.1)、23.3%(±10.1)和14.4%(±9.0)(p<0.01)。此外,注射内皮素后,毛细血管直径增加(p<0.01),毛细血管间隙减小(p<0.01),但并非呈线性剂量依赖性。内皮素剂量与平均体循环血压变化(r = 0.82,p<0.01)和平均肺动脉血压变化(r = 0.80,p<0.01)相关。平均肺动脉压力变化与铸型上的局部静脉收缩(r = 0.35,p<0.01)以及毛细血管直径(r = 0.64,p<0.01)和毛细血管间隙距离(r = -0.34,p<0.01)相关。静脉收缩与毛细血管直径相关(r = 0.26,p<0.01)。内皮素-1对大鼠肺微循环最显著的影响是小静脉的局部收缩。由于这种作用可能导致肺水肿,内皮素拮抗剂在多种临床情况下可能有益。