Alper C M, Tabari R, Seroky J T, Doyle W J
Department of Otolaryngology, Children's Hospital of Pittsburgh, PA, USA.
Acta Otolaryngol. 1995 Jan;115(1):55-60. doi: 10.3109/00016489509133347.
To test the hypothesis that changes in mucosal perfusion could influence gas exchange and thus, middle ear pressure, the effects of systemically administered drugs showing alpha adrenergic effects on mucosal perfusion and middle ear pressure were evaluated in 4 cynomolgus monkeys. Two drugs with well characterized sympathomimetic effects, dopamine and dobutamine, were studied, and dopamine was combined with an antagonist, phentolamine. For each experiment, the monkeys were anesthetized with pentobarbital and followed for a 90 min baseline period. Then, the drug was administered for 60 min with follow-up extending through that period and for an additional 60 min. Data consisted of repeated measurements of rectal temperature, heart rate, blood pressure, left middle ear pressure and right mucosal blood velocity, volume and flow. The results documented an increase in middle ear pressure after intravenous infusion of either dopamine or dobutamine and an attenuation of the response by concurrent administration of phentolamine. Laser Doppler measurements documented a variable, non-directional change in blood volume, velocity and flow. The changes in the middle ear pressure observed following systemic administration of autonomic drugs are consistent with the rapid establishment of a transmucosal pressure gradient secondary to changes in the supply and/or metabolism of gases.
为了验证黏膜灌注的变化可能影响气体交换,进而影响中耳压力这一假说,在4只食蟹猴中评估了全身给药后显示α肾上腺素能效应的药物对黏膜灌注和中耳压力的影响。研究了两种具有明确拟交感神经效应的药物,多巴胺和多巴酚丁胺,并将多巴胺与拮抗剂酚妥拉明联合使用。每次实验时,用戊巴比妥麻醉猴子,并记录90分钟的基线期。然后给药60分钟,随访期持续至给药期及额外的60分钟。数据包括对直肠温度、心率、血压、左中耳压力和右黏膜血流速度、血容量及血流量的重复测量。结果表明,静脉输注多巴胺或多巴酚丁胺后中耳压力升高,而同时给予酚妥拉明可减弱该反应。激光多普勒测量显示血容量、血流速度和血流量发生了可变的、无方向性的变化。全身给予自主神经药物后观察到的中耳压力变化与气体供应和/或代谢变化继发的跨黏膜压力梯度的快速建立一致。