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膀胱扩张:其对犬颈动脉压力感受器反射左心室变力反应的影响。

Urinary bladder distension: its effects on carotid baroreceptor reflex left ventricular inotropic response in the dog.

作者信息

Ward J, Daly M B, Wood L M

机构信息

Department of Physiology, United Medical and Dental Schools of Guy's and St Thomas' Hospitals, London, UK.

出版信息

J Physiol. 1995 Dec 15;489 ( Pt 3)(Pt 3):857-68. doi: 10.1113/jphysiol.1995.sp021098.

Abstract
  1. The effects of distension of the urinary bladder on heart rate, maximum rate of change of left ventricular pressure (dP/dt max) and hindlimb vascular resistance together with their modulation at different carotid sinus pressures were studied in dogs anaesthetized with a mixture of chloralose and urethane and artificially ventilated. 2. When the carotid sinus mean perfusion pressure was raised in randomly selected steps from 60 to 210 mmHg, it caused a progressive bradycardia, and a reduction in left ventricular dP/dt max and in arterial blood pressure, together with vasodilatation in the perfused hindlimb. Distension of the bladder at each level of carotid sinus pressure resulted in tachycardia, a small but significant increase in left ventricular dP/dt max (160 +/- 30 mmHg s-1) and hindlimb vasoconstriction. 3. When heart rate and arterial blood pressure were held constant to exclude these secondary effects on left ventricular dP/dt max, raising the carotid sinus pressure caused a progressive reduction in left ventricular dP/dt max and hindlimb vasodilatation. Superimposition of tests of bladder distension at each level of sinus pressure resulted in variable responses, but overall there was a significant increase in left ventricular dP/dt max of 190 +/- 54 mmHg s-1. Hindlimb vasocontriction, however, was a consistent finding. 4. The gain of the relationship between the carotid sinus perfusion pressure and left ventricular dP/dt max was unaffected by distension of the bladder. 5. It is concluded that, when changes secondary to increases in heart rate and blood pressure are prevented, distension of the bladder causes a small but significant reflex increase in left ventricular dP/dt max. The responses, however, are variable and the possible reasons for this are discussed.
摘要
  1. 本研究在使用水合氯醛和乌拉坦混合麻醉并进行人工通气的犬身上,探讨了膀胱扩张对心率、左心室压力最大变化率(dP/dt max)和后肢血管阻力的影响,以及在不同颈动脉窦压力下这些影响的调节情况。2. 当随机逐步将颈动脉窦平均灌注压从60 mmHg提高到210 mmHg时,会导致渐进性心动过缓、左心室dP/dt max降低、动脉血压下降,同时灌注后肢血管舒张。在每个颈动脉窦压力水平下膀胱扩张都会导致心动过速、左心室dP/dt max小幅但显著增加(160±30 mmHg s-1)以及后肢血管收缩。3. 当心率和动脉血压保持恒定时,以排除对左心室dP/dt max的这些继发影响,提高颈动脉窦压力会导致左心室dP/dt max逐渐降低和后肢血管舒张。在每个窦压力水平叠加膀胱扩张试验会产生不同的反应,但总体上左心室dP/dt max显著增加190±54 mmHg s-1。然而,后肢血管收缩是一个一致的发现。4. 颈动脉窦灌注压力与左心室dP/dt max之间关系的增益不受膀胱扩张的影响。5. 得出的结论是,当防止因心率和血压升高引起的继发变化时,膀胱扩张会导致左心室dP/dt max出现小幅但显著的反射性增加。然而,这些反应是可变的,并对此可能的原因进行了讨论。

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