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缺血及无氧灌注期间外周血管床的微血管功能

Microvascular function in the peripheral vascular bed during ischaemia and oxygen-free perfusion.

作者信息

Paaske W P, Sejrsen P

机构信息

Vascular Surgery Unit, Skejby Hospital, Aarhus University Hospital, Denmark.

出版信息

Eur J Vasc Endovasc Surg. 1995 Jan;9(1):29-37. doi: 10.1016/s1078-5884(05)80221-7.

Abstract

OBJECTIVES

To determine the influence of acute ischaemia and absence of leukocytes on the microvascular function and capillary permeability in skeletal muscle.

DESIGN

Prospective, open study.

SETTING

University Department of Vascular Surgery and Institute of Medical Physiology.

MATERIALS AND METHODS

Ten isolated cat gastrocnemius muscles were perfused with oxygen-free Ringer-albumin solution through the femoral artery. At 5 microliters bolus with 14.8 MBq 51Cr-EDTA was injected through a side branch into the femoral artery, and the response function was detected over the muscle by a scintillation detector connected to a spectrometer and a computer. The perfusion coefficient was measured directly at the venous outlet. The response function was analysed in accordance with non-compartmental black box kinetic principles to give perfusion rate, capillary extraction fraction and capillary diffusional permeability-surface area product (PdS). In separate experiments the molecular size and the free diffusion coefficient of 51Cr-EDTA in water at 37 degrees C were determined by a modified true transient diffusion method.

MAIN RESULTS

During perfusion the PdS-product increased as a function of flow rate, f, in accordance with the linear regression line PdS = 1.78 + 0.15 f between 5 to 60 ml/100 g/min. This permeative conductance was identical to that found previously in a similar experimental set up with oxygenated whole blood perfusion. During oxygen free perfusion the perfusion rate was a linear function of arterial perfusion pressure, and autoregulation of blood flow did not occur in response to variations of arterial perfusion pressures. The free diffusion coefficient in water at 37 degrees C for 51Cr-EDTA was 7.4 x 10(-6) cm2/s (n = 36), which corresponds to a Stokes-Einstein molecular radius, rSE, of 0.439 nm.

CONCLUSIONS

In spite of complete anoxia and absence of normal microcirculatory flow regulating mechanisms there is no sign of changes in capillary diffusional permeability for smaller hydrophilic molecules and functional membrane damage is not elicited in the absence of oxygen under these conditions.

摘要

目的

确定急性缺血和白细胞缺失对骨骼肌微血管功能及毛细血管通透性的影响。

设计

前瞻性开放性研究。

地点

大学血管外科系和医学生理学研究所。

材料与方法

通过股动脉向10只离体猫的腓肠肌灌注无氧林格白蛋白溶液。经股动脉侧支以5微升推注的方式注入含14.8兆贝可51铬 - 乙二胺四乙酸(51Cr - EDTA),并通过与光谱仪和计算机相连的闪烁探测器在肌肉上方检测响应函数。在静脉出口直接测量灌注系数。根据非房室黑箱动力学原理分析响应函数,以得出灌注率、毛细血管提取分数和毛细血管扩散通透表面积乘积(PdS)。在单独实验中,采用改良的真瞬态扩散法测定37℃时51Cr - EDTA在水中的分子大小和自由扩散系数。

主要结果

灌注过程中,PdS乘积随流速f呈函数增加,在5至60毫升/100克/分钟之间符合线性回归线PdS = 1.78 + 0.15f。这种通透传导率与先前在类似实验装置中用含氧全血灌注时发现的相同。在无氧灌注期间,灌注率是动脉灌注压力的线性函数,并且未发生因动脉灌注压力变化而引起的血流自动调节。37℃时51Cr - EDTA在水中的自由扩散系数为7.4×10−6平方厘米/秒(n = 36),这对应于斯托克斯 - 爱因斯坦分子半径rSE为0.439纳米。

结论

尽管完全缺氧且缺乏正常的微循环血流调节机制,但对于较小的亲水分子,毛细血管扩散通透性没有变化的迹象,并且在这些条件下无氧状态下未引发功能性膜损伤。

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