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大肠杆菌内毒素血症会改变冠状动脉和肺小动脉对血小板产物的反应。

Escherichia coli endotoxemia alters coronary and pulmonary arteriolar responses to platelet products.

作者信息

Sellke F W, Wang S Y, VanderMeer T J, Fink M P

机构信息

Department of Surgery, Beth Israel Hospital, Boston, Massachusetts 02215, USA.

出版信息

Shock. 1994 Apr;1(4):279-85. doi: 10.1097/00024382-199404000-00006.

DOI:10.1097/00024382-199404000-00006
PMID:7735962
Abstract

In order to examine the effects of Escherichia coli endotoxemia on coronary and pulmonary microvascular responses to serotonin (5-HT) and ADP, arterioles (80-190 micros diameter) were isolated from pigs 3 h after administration of E. coli endotoxin (150 micrograms/kg, intravenously over 1 h, n = 8) or Ringer's lactate (control, n = 8). Arterioles were studied in vitro in a pressurized, partially contracted, no-flow state with video-microscopy. Precontracted (30-50% of baseline diameter) control coronary arterioles dilated in responses to either 5-HT (24 +/- 2%) or ADP (89 +/- 2%). These relaxations were partially inhibited by indomethacin, but were markedly reduced with nitric oxide synthase inhibition. After 3 h of endotoxemia, 5-HT caused contraction of coronary arterioles which was inhibited with indomethacin. In the presence of indomethacin, coronary vessels from endotoxic pigs relaxed slightly, but significantly, more to 5-HT than did control vessels exposed to indomethacin. In contrast, the relaxation response to ADP was unchanged following endotoxemia. Precontracted (15-30% of baseline diameter) pulmonary arterioles dilated in response to 5-HT (13 +/- 1%) or ADP (67 +/- 3%). Following 3 h of endotoxemia, the pulmonary arteriolar relaxation induced by 5-HT was reduced, whereas the response to ADP was not altered. In both coronary and pulmonary arterioles, relaxation induced by the endothelium-independent vasodilator, sodium nitroprusside, was unaffected by endotoxemia. Thus, coronary and pulmonary microvascular relaxation response to ADP are minimally affected by 3 h of endotoxemia, but relaxation responses to 5-HT are significantly reduced or converted to contractile responses.

摘要

为了研究大肠杆菌内毒素血症对冠状动脉和肺微血管对5-羟色胺(5-HT)和二磷酸腺苷(ADP)反应的影响,在静脉注射大肠杆菌内毒素(150微克/千克,1小时内静脉注射完毕,n = 8)或乳酸林格液(对照组,n = 8)3小时后,从猪身上分离出小动脉(直径80 - 190微米)。利用视频显微镜在体外对处于加压、部分收缩、无血流状态的小动脉进行研究。预收缩(基线直径的30 - 50%)的对照冠状动脉小动脉对5-HT(24±2%)或ADP(89±2%)产生舒张反应。这些舒张反应部分被吲哚美辛抑制,但在一氧化氮合酶抑制时显著降低。内毒素血症3小时后,5-HT导致冠状动脉小动脉收缩,该收缩被吲哚美辛抑制。在吲哚美辛存在的情况下,内毒素血症猪的冠状动脉对5-HT的舒张程度虽轻微但显著大于暴露于吲哚美辛的对照血管。相比之下,内毒素血症后对ADP的舒张反应未改变。预收缩(基线直径的15 - 30%)的肺小动脉对5-HT(13±1%)或ADP(67±3%)产生舒张反应。内毒素血症3小时后,5-HT诱导的肺小动脉舒张减弱,而对ADP的反应未改变。在冠状动脉和肺小动脉中,内皮依赖性血管舒张剂硝普钠诱导的舒张不受内毒素血症影响。因此,3小时的内毒素血症对冠状动脉和肺微血管对ADP的舒张反应影响极小,但对5-HT的舒张反应显著降低或转变为收缩反应。

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