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组织压力升高和降低对猫骨骼肌血流动力学及毛细血管活动的影响。

Effects of increased and decreased tissue pressure on haemodynamic and capillary events in cat skeletal muscle.

作者信息

Mellander S, Albert U

机构信息

Department of Physiology and Biophysics, University of Lund, Sweden.

出版信息

J Physiol. 1994 Nov 15;481 ( Pt 1)(Pt 1):163-75. doi: 10.1113/jphysiol.1994.sp020427.

Abstract
  1. The controversial problem concerning the unusual haemodynamics of the deranged circulation during increased hydrostatic tissue pressure (PT) was elucidated by detailed studies of arterial, capillary and venous functions in cat skeletal muscle exposed to graded experimental changes of PT over a wide range. 2. The results indicated that the impaired circulatory state in skeletal muscle during raised tissue pressure is characterized by the following train of events: (a) a primary partial passive compression of the most distal part of the venous system due to negative vascular transmural pressure selectively at this site, in turn leading to the prompt development of a distinct 'venous outflow orifice resistance' graded in relation to the PT rise; (b) a consequent reduction of blood flow graded in relation to this resistance increase; (c) a rise in intramuscular venous pressure proximal of the 'venous outflow orifice' by the same extent as the PT increase; (d) transmission of the raised venous pressure to more proximal vessels in relation to the prevailing segmental resistance ratios; (e) a consequent maintenance of clearly positive transmural pressures in all vascular sections proximal to the 'venous outflow orifice', preventing collapse of these vessels; (f) maintenance of a largely normal capillary filtration coefficient and functional capillary surface area; and (g) an increase in capillary pressure by approximately 85% of the PT rise which reduces the rate of net transcapillary fluid absorption to about one-seventh of that expected from the PT rise per se. 3. Previous concepts of a 'vascular waterfall phenomenon', a capillary collapse, or an arteriolar 'critical closure phenomenon' did not seem to be valid for the skeletal muscle circulation during increased PT. 4. The rate of net transcapillary fluid flux per unit PT change was much smaller during positive than negative PT, since capillary pressure rose considerably when PT was increased above control, but was largely unchanged when PT was decreased below control. 5. Possible ways to improve the circulatory state in conditions with an oedema-induced tissue pressure rise are discussed.
摘要
  1. 通过对猫骨骼肌中动脉、毛细血管和静脉功能进行详细研究,该研究在较大范围内对组织静水压(PT)进行分级实验性改变,从而阐明了关于组织静水压升高期间紊乱循环中异常血流动力学的这一有争议的问题。2. 结果表明,组织压力升高期间骨骼肌循环状态受损的特征如下一系列事件:(a)由于该部位血管跨壁压力为负,静脉系统最远端部分首先出现部分被动受压,进而导致与PT升高相关的明显“静脉流出孔阻力”迅速形成;(b)随之而来的是与这种阻力增加相关的血流减少;(c)“静脉流出孔”近端的肌内静脉压力升高幅度与PT升高幅度相同;(d)升高的静脉压力根据当时的节段阻力比传递至更近端的血管;(e)因此,“静脉流出孔”近端所有血管段的跨壁压力保持明显为正,防止这些血管塌陷;(f)维持基本正常的毛细血管滤过系数和功能性毛细血管表面积;(g)毛细血管压力升高约为PT升高幅度的85%,这将毛细血管净液体吸收速率降低至仅为PT升高本身预期值的约七分之一。3. 先前关于“血管瀑布现象”、毛细血管塌陷或小动脉“临界关闭现象”的概念似乎不适用于PT升高期间的骨骼肌循环。4. 单位PT变化时的毛细血管净液体通量率在PT为正时比为负时小得多,因为当PT高于对照值时毛细血管压力大幅升高,但当PT低于对照值时基本不变。5. 讨论了在水肿引起组织压力升高的情况下改善循环状态的可能方法。

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