Lübbe A S, Harris P D, Garrison R N
Department of Medicine/Oncology, R. Virchow Medical School, Freie Universität Berlin, Germany.
Circ Shock. 1993 Jul;40(3):157-67.
Renovascular hypertension profoundly alters skeletal muscle arteriolar responses to sepsis, yet systemic hemodynamics to sepsis are not affected by hypertension. In this study, we hypothesized that microvascular responses of skeletal muscle and systemic hemodynamics are changed during high- and low-cardiac-output Escherichia coli bacteremia in normotensive Wistar-Kyoto (WKY) and spontaneously hypertensive rats (SHR). During high-cardiac-output bacteremia, blood pressure and heart rate increased in WKY, but blood pressure decreased in SHR. During low-cardiac-output bacteremia, blood pressure initially decreased in WKY, while in SHR, pressure dropped significantly and remained severely depressed. Heart rate increased by 50% in SHR, but only by 10-15% in WKY during low-cardiac-output bacteremia. Large A1 and A2 arterioles constricted in both WKY and SHR during both phases of bacteremia. Small A3 and A4 arterioles dilated in WKY during bacteremia, but this small arteriole dilation was blunted in SHR. However, nitroprusside, an endothelium-derived relaxing factor (EDRF)-independently acting vasodilator, caused maximal dilation of these small arterioles of SHR. We conclude that there are profound changes and differences in systemic hemodynamics during bacteremia between the normotensive and the genetically hypertensive groups, whereas despite a possibly decreased endothelium-dependent vasodilator responsiveness in small arterioles of SHR during bacteremia, overall blood flow changes in skeletal muscle were similar among the two groups.
肾血管性高血压会深刻改变骨骼肌小动脉对脓毒症的反应,然而脓毒症时的全身血流动力学不受高血压影响。在本研究中,我们假设在正常血压的Wistar-Kyoto(WKY)大鼠和自发性高血压大鼠(SHR)发生高心输出量和低心输出量大肠杆菌菌血症期间,骨骼肌的微血管反应和全身血流动力学发生了变化。在高心输出量菌血症期间,WKY大鼠的血压和心率升高,但SHR大鼠的血压下降。在低心输出量菌血症期间,WKY大鼠的血压最初下降,而SHR大鼠的血压显著下降并持续严重降低。在低心输出量菌血症期间,SHR大鼠的心率增加了50%,而WKY大鼠仅增加了10%-15%。在菌血症的两个阶段,WKY大鼠和SHR大鼠的大A1和A2小动脉均收缩。菌血症期间WKY大鼠的小A3和A4小动脉扩张,但SHR大鼠的这种小动脉扩张减弱。然而,硝普钠,一种不依赖内皮衍生舒张因子(EDRF)起作用的血管扩张剂,可使SHR大鼠的这些小动脉产生最大程度的扩张。我们得出结论,正常血压组和遗传性高血压组在菌血症期间的全身血流动力学存在深刻变化和差异,而尽管SHR大鼠在菌血症期间小动脉的内皮依赖性血管扩张反应性可能降低,但两组骨骼肌的总体血流变化相似。