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[一氧化氮对经窦主动脉去神经支配诱导的肺动脉高压和系统性高血压无影响]

[Absence of the effect of nitric oxide on pulmonary and systemic hypertension induced by sino-aortic denervation].

作者信息

Galinier M, Rougé P, Albenque J P, Assoun B, Massabuau P, Fauvel J M, Bounhoure J P, Montastruc J L, Montastruc P

机构信息

Service de cardiologie et de chirurgie cardiovasculaire, Hôpital Rangueil, Toulouse.

出版信息

Arch Mal Coeur Vaiss. 1995 Aug;88(8):1209-12.

PMID:8572875
Abstract

Inhaled nitric oxide, a selective pulmonary vasodilator, reverses hypoxic pulmonary vasoconstriction and is an effective treatment in some cases of human pulmonary hypertension. Localization of nitric oxide synthase had indicated a neural role for nitric oxide. Thus, we studied the interactions between inhaled nitric oxide and systemic and pulmonary vascular reactivity in acute neurogenic hypertension. In 6 male beagle dogs (mean weight: 15 +/- 1 kg), anesthetized by chloralose (8 cg/kg) and in spontaneous ventilation, the hemodynamic effects on systemic and pulmonary circulation of inhaled nitric oxide (12 ppm) were studied before and after acute sino-aortic denervation. The hemodynamic effects of intravenous propranolol (300 micrograms/kg) were studied after denervation. Mean arterial pressure (MAP), pulmonary capillary pressure (PCP), mean arterial pulmonary pressure (MAPP), cardiac input (CI) and oxygen venous saturation (SvO2) were measured. [table: see text] Sino-aortic denervation causes an acute and transitory pulmonary hypertension due to a double mechanism: a post-capillary hypertension (increase PCP) secondary to an increase left ventricular post-charge by systemic hypertension and a precapillary hypertension. In fact, vascular pulmonary resistances increase from 1.8 +/- 0.1 to 3.4 +/- 0.8 uW after denervation (p < 0.05). Change in pulmonary vascular reactivity induced by catecholamines is probably involved. Propranolol but not inhaled nitric oxide reverse pulmonary hypertension due to sino-aortic denervation.

摘要

吸入一氧化氮是一种选择性肺血管扩张剂,可逆转低氧性肺血管收缩,在某些人类肺动脉高压病例中是一种有效的治疗方法。一氧化氮合酶的定位表明一氧化氮具有神经作用。因此,我们研究了急性神经源性高血压中吸入一氧化氮与全身和肺血管反应性之间的相互作用。在6只雄性比格犬(平均体重:15±1千克)中,用氯醛糖(8厘克/千克)麻醉并自主通气,在急性去窦主动脉神经支配前后研究了吸入一氧化氮(12 ppm)对全身和肺循环的血流动力学影响。去神经支配后研究了静脉注射普萘洛尔(300微克/千克)的血流动力学影响。测量平均动脉压(MAP)、肺毛细血管压(PCP)、平均动脉肺动脉压(MAPP)、心输出量(CI)和氧静脉饱和度(SvO2)。[表:见正文]去窦主动脉神经支配由于双重机制导致急性和短暂性肺动脉高压:一种是毛细血管后高血压(PCP升高),继发于全身高血压引起的左心室后负荷增加,另一种是毛细血管前高血压。事实上,去神经支配后肺血管阻力从1.8±0.1增加到3.4±0.8微瓦(p<0.05)。可能涉及儿茶酚胺引起的肺血管反应性变化。普萘洛尔而非吸入一氧化氮可逆转去窦主动脉神经支配引起的肺动脉高压。

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