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麻醉猪胆囊扩张引起的反射性冠状动脉收缩。

Reflex coronary vasoconstriction caused by gallbladder distension in anesthetized pigs.

作者信息

Vacca G, Battaglia A, Grossini E, Mary D A, Molinari C

机构信息

Dipartimento di Scienze Mediche, Facoltà di Medicina e Chirurgia di Novara, Università di Torino, Italy.

出版信息

Circulation. 1996 Nov 1;94(9):2201-9. doi: 10.1161/01.cir.94.9.2201.

Abstract

BACKGROUND

Gallbladder distension in anesthetized pigs reflexly increases heart rate and arterial pressure by means of afferent vagal pathways and efferent sympathetic mechanisms. The effect of such distension on the coronary circulation is unknown. The present study was undertaken to determine whether gallbladder distension primarily causes reflex changes in left circumflex blood flow.

METHODS AND RESULTS

In 21 pigs anesthetized with sodium pentobarbitone (16) or alpha-chloralose (5), left circumflex blood flow was measured with an electromagnetic flowmeter. A balloon positioned within the gallbladder was distended with volumes of Ringer's solution equal to the volumes of bile previously withdrawn (mean vol: 62 mL; mean gallbladder pressure: 12 mm Hg). Heart rate and arterial pressure were kept constant by atrial pacing and by a pressurized reservoir connected to the left femoral artery. Gallbladder distension always caused a decrease in circumflex blood flow. In 6 of the 16 sodium pentobarbitone-anesthetized pigs, this decrease was graded by step increments of distension. In 5 of these 16 pigs, the decrease in circumflex blood flow was not affected by atropine. In 10 of these 16 pigs, including those given atropine, the response was not affected by propranolol but was abolished by subsequently giving phentolamine. Cervical vagotomy abolished the coronary vasoconstriction in the remaining 6 pigs. In the 5 alpha-chloralose-anesthetized pigs, the response was not significantly affected by cutting the splanchnic nerves but was abolished by subsequent cervical vagotomy.

CONCLUSIONS

The present study showed that innocuous distension of the gallbladder in anesthetized pigs caused a reflex coronary vasoconstriction that involved efferent sympathetic mechanisms related to alpha-adrenoceptors and afferent vagal pathways.

摘要

背景

麻醉猪的胆囊扩张通过迷走神经传入通路和交感神经传出机制反射性地增加心率和动脉压。这种扩张对冠状动脉循环的影响尚不清楚。本研究旨在确定胆囊扩张是否主要引起左旋支血流的反射性变化。

方法与结果

用戊巴比妥钠(16只)或α-氯醛糖(5只)麻醉21只猪,用电磁流量计测量左旋支血流。将一个置于胆囊内的球囊用与先前抽出的胆汁体积相等的林格氏液充盈(平均体积:62 mL;平均胆囊压力:12 mmHg)。通过心房起搏和连接到左股动脉的加压贮液器使心率和动脉压保持恒定。胆囊扩张总是导致左旋支血流减少。在16只戊巴比妥钠麻醉的猪中,有6只这种减少随扩张程度逐步增加。在这16只猪中的5只,左旋支血流的减少不受阿托品影响。在这16只猪中的10只,包括给予阿托品的那些猪,反应不受普萘洛尔影响,但随后给予酚妥拉明可消除该反应。在其余6只猪中,颈迷走神经切断术消除了冠状动脉收缩。在5只α-氯醛糖麻醉的猪中,切断内脏神经对反应无显著影响,但随后的颈迷走神经切断术可消除该反应。

结论

本研究表明,麻醉猪胆囊的无害扩张引起反射性冠状动脉收缩,这涉及与α-肾上腺素能受体相关的交感神经传出机制和迷走神经传入通路。

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