Li J X, Kelly D R, Oliver J R, Grantham K D, Philips J B
Department of Pediatrics, University of Alabama at Birmingham 35233-7335, USA.
Shock. 1994 Aug;2(2):98-105. doi: 10.1097/00024382-199408000-00004.
The parasympathetic nervous system actively participates in the regulation of pathophysiologic responses in circulatory shock. To determine the effects of cholinergic blockade in endotoxic shock in newborn piglets, 16 chronically instrumented newborn piglets were infused with 10 mg/kg of endotoxin over 10 min. Eight animals were injected intravenously with 10 mg/kg of anisodamine, an anticholinergic drug, 10 min before endotoxin and then with escalating doses of 2, 5, 10, and 20 mg/kg every 10 min, beginning 60 min after endotoxin. The other eight animals were given saline as a control. Endotoxin infusion caused elevations in mean pulmonary artery pressure and vascular resistance index and an initial increase in systemic artery pressure followed by hypotension. Heart rate was stable for 45 min and then increased. Cardiac index fell from a baseline of 173 +/- 20 (mean +/- S.E.) to 136 +/- 23 mL.min-1.kg-1 60 min after endotoxin. Pretreatment with anisodamine increased heart rate from 163 +/- 15 to 289 +/- 10 beats.min-1 and cardiac index from 195 +/- 15 to 238 +/- 14 mL.min-1.kg-1 before endotoxin infusion. These variables remained at higher levels than in the control group until 60 min after endotoxin infusion; thereafter, the two groups were similar. The changes in pulmonary and systemic artery pressures were not significantly altered by anisodamine. After 60 min, additional doses of anisodamine caused no significant hemodynamic responses, and the differences between the two groups were not significant. Arterial plasma thromboxane B2 levels rose immediately and tumor necrosis factor-alpha levels increased 60 min after endotoxin infusion; no significant differences were noted between groups at any time.(ABSTRACT TRUNCATED AT 250 WORDS)
副交感神经系统积极参与循环性休克病理生理反应的调节。为确定胆碱能阻断对内毒素休克新生仔猪的影响，16只长期植入仪器的新生仔猪在10分钟内输注10mg/kg内毒素。8只动物在输注内毒素前10分钟静脉注射10mg/kg山莨菪碱（一种抗胆碱能药物），然后在内毒素注射60分钟后，每隔10分钟依次注射递增剂量的2、5、10和20mg/kg。另外8只动物给予生理盐水作为对照。输注内毒素导致平均肺动脉压和血管阻力指数升高，全身动脉压最初升高随后降低。心率在45分钟内保持稳定，然后升高。心脏指数从基线的173±20（平均值±标准误）在内毒素注射60分钟后降至136±23mL·min⁻¹·kg⁻¹。山莨菪碱预处理使心率从163±15次/分钟升至289±10次/分钟，心脏指数从195±15升至238±14mL·min⁻¹·kg⁻¹，在内毒素输注前。这些变量在内毒素输注60分钟前一直高于对照组；此后，两组相似。山莨菪碱对肺和全身动脉压的变化无明显影响。60分钟后，额外剂量的山莨菪碱未引起明显的血流动力学反应，两组间差异无统计学意义。动脉血浆血栓素B2水平立即升高，肿瘤坏死因子-α水平在内毒素输注60分钟后升高；两组在任何时间均无显著差异。（摘要截断于250字）
