Abensur H, Romão Júnior J E, Prado E B, Kakehashi E, Sabbaga E, Marcondes M
Hospital Das Clínicas, São Paulo University, Brazil.
Adv Perit Dial. 1993;9:16-20.
The lymphatic vessels have sympathetic innervation. Noradrenaline increases the number of spontaneous contractions of the lymphatic vessels, whereas isoprenaline slows these contractions. The purpose of this study was to analyze the influence of the blockade of spontaneous contractions of the lymphatic vessels on the lymphatic absorption rate (LAR) in 6 patients on continuous ambulatory peritoneal dialysis (CAPD) by using 0.12 mg of isoprenaline added to 2 L of 2.5% dextrose dialysis solution. This dose of isoprenaline has been shown to inhibit bovine mesenteric lymphatic contractions. The LAR was measured by the quantification of the intraperitoneal disappearance of dextran 70 added to this same dialysis solution during a 4-hour dwell. All patients were submitted to a control test without isoprenaline. The LAR was 0.57 +/- 0.19 and 0.65 +/- 0.38 mL/minute (p > 0.05), with and without isoprenaline, respectively. We conclude that spontaneous contractions of the lymphatic vessels do not play an important role in the lymphatic drainage mechanism of the peritoneal cavity. The diaphragmatic contractions seem to be more important, since drugs that interfere with such diaphragmatic mechanisms alter the LAR.
淋巴管接受交感神经支配。去甲肾上腺素可增加淋巴管自发收缩的次数,而异丙肾上腺素则会减缓这些收缩。本研究的目的是通过在2升2.5%葡萄糖透析液中添加0.12毫克异丙肾上腺素,分析阻断6例持续性非卧床腹膜透析(CAPD)患者淋巴管自发收缩对淋巴吸收速率(LAR)的影响。已证明该剂量的异丙肾上腺素可抑制牛肠系膜淋巴管收缩。通过在4小时留腹期间对添加到同一透析液中的右旋糖酐70在腹腔内的消失情况进行定量来测量LAR。所有患者均接受了无异丙肾上腺素的对照试验。有和无异丙肾上腺素时,LAR分别为0.57±0.19和0.65±0.38毫升/分钟(p>0.05)。我们得出结论,淋巴管的自发收缩在腹膜腔淋巴引流机制中并不起重要作用。膈肌收缩似乎更为重要,因为干扰此类膈肌机制的药物会改变LAR。