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一氧化氮在脑血管对高碳酸血症反应中的作用。

The role of nitric oxide in the cerebrovascular response to hypercapnia.

作者信息

Smith J J, Lee J G, Hudetz A G, Hillard C J, Bosnjak Z J, Kampine J P

机构信息

Department of Anesthesiology, Medical College of Wisconsin, Milwaukee 53226, USA.

出版信息

Anesth Analg. 1997 Feb;84(2):363-9. doi: 10.1097/00000539-199702000-00023.

Abstract

Laser Doppler flowmetry was used to further investigate the role of nitric oxide (NO) in CO2-induced cerebrocortical hyperemia in rats. A second objective was to elucidate the source(s) of the NO involved in the response to hypercapnia. We used the L-arginine analogue N omega-nitro-L-arginine methyl ester (L-NAME) to inhibit NO synthase (NOS) and 7-nitroindazole (7-NI) to selectively inhibit brain or nonendothelial NOS. Rats were anesthetized with a single dose of intraperitoneal (IP) pentobarbital (65 mg/kg) for surgery; 60-90 min later they were ventilated with 1.0% halothane in 30% O2 for 1 h to achieve a steady state. The animals were assigned to one of five groups. A control group (n = 9) was infused with 1 mL of saline. The second group (n = 10) received 20 mg/kg of L-NAME intravenously (IV). A third group (n = 9) also received L-NAME; in addition, cerebrocortical laser Doppler flow (LDF) and mean arterial pressure (MAP) were restored to baseline using the NO donor sodium nitroprusside (SNP). In a fourth group (n = 9), MAP was increased to the level usually seen after L-NAME with an infusion of phenylephrine (0.5-5 micrograms.kg-1.min-1). A fifth group (n = 11) received 7-NI at 40 mg/kg IP. The hypercapnic response of LDF was tested in all groups by adding 5% CO2 to the inspired gas at 30-45 min posttreatment; all changes in LDF were significant. In the control group, hypercapnia induced a 70% +/- 24% increase in LDF. In the L-NAME-treated group, the response was decreased to 36% +/- 22% at a posttreatment LDF that was 25% +/- 13% lower than the pre-L-NAME level. In the group where baseline LDF and MAP were restored with SNP, the CO2 response was 56% +/- 15% (not significant versus control). In the group in which MAP was increased with phenylephrine, the response to hypercapnia was 48% +/- 22% at a posttreatment LDF unchanged from pretreatment. These data suggest that increased vascular tone or the absence of basal NO after NOS inhibition influenced the vasodilator response to hypercapnia. In the 7-NI-treated group the response to hypercapnia was 38% +/- 3%, significantly attenuated at a posttreatment flow only 14% +/- 7% lower than pre-7-NI. We conclude that 1) endothelial NO does not mediate the response to hypercapnia but may have a permissive role in the response and 2) that brain NO may have an important role in response to hypercapnia.

摘要

激光多普勒血流仪用于进一步研究一氧化氮(NO)在大鼠二氧化碳诱导的大脑皮质充血中的作用。第二个目的是阐明参与高碳酸血症反应的NO的来源。我们使用L-精氨酸类似物Nω-硝基-L-精氨酸甲酯(L-NAME)抑制一氧化氮合酶(NOS),并使用7-硝基吲唑(7-NI)选择性抑制脑或非内皮NOS。大鼠通过单次腹腔注射(IP)戊巴比妥(65mg/kg)麻醉以进行手术;60-90分钟后,用含1.0%氟烷的30%氧气通气1小时以达到稳态。动物被分为五组之一。对照组(n = 9)输注1mL生理盐水。第二组(n = 10)静脉注射(IV)20mg/kg的L-NAME。第三组(n = 9)也接受L-NAME;此外,使用NO供体硝普钠(SNP)将大脑皮质激光多普勒血流(LDF)和平均动脉压(MAP)恢复到基线水平。第四组(n = 9)通过输注去氧肾上腺素(0.5-5μg·kg-1·min-1)将MAP提高到通常在L-NAME后出现的水平。第五组(n = 11)腹腔注射40mg/kg的7-NI。在治疗后30-45分钟,通过向吸入气体中添加5%二氧化碳来测试所有组中LDF的高碳酸血症反应;LDF的所有变化均具有统计学意义。在对照组中,高碳酸血症使LDF增加70%±24%。在L-NAME治疗组中,治疗后的反应降至36%±22%,此时治疗后的LDF比L-NAME治疗前水平低25%±13%。在使用SNP恢复基线LDF和MAP的组中,二氧化碳反应为56%±15%(与对照组相比无统计学意义)。在使用去氧肾上腺素使MAP升高的组中,高碳酸血症反应在治疗后的LDF与治疗前无变化时为48%±22%。这些数据表明,血管张力增加或NOS抑制后基础NO的缺乏影响了对高碳酸血症的血管舒张反应。在7-NI治疗组中,对高碳酸血症的反应为38%±3%,在治疗后的血流仅比7-NI治疗前低14%±7%时显著减弱。我们得出结论:1)内皮NO不介导对高碳酸血症的反应,但可能在该反应中起允许作用;2)脑NO可能在对高碳酸血症的反应中起重要作用。

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