Irwin R S, Martinez-Gonzalez-Rio J, Thomas H M, Fritts H W
J Clin Invest. 1977 Dec;60(6):1258-65. doi: 10.1172/JCI108885.
We studied the effect of diffuse granulomatous pulmonary disease on the reponse of the pulmonary circulation to hypoxia in two series of experiments in intact dogs. First, in animals with unilateral disease, vasoconstriction in the diseased lung was compared to that in the contralateral control lung. Second, in animals with bilateral disease, the vasoconstriction of pulmonary shunt pathways was compared to that of the rest of the pulmonary vasculature. We assessed vasoconstriction in each study by measuring the distribution of pulmonary blood flow between the test and control set of vessels during 21 and 12% oxygen breathing. In the first set of experiments, we measured apportionment of the blood flow between the two lungs by bronchospirometry and the krypton bolus method. In normal dogs, hypoxia did not shift blood flow systematically from one lung to the other. In 10 dogs with unilateral disease, general hypoxia increased the proportion of blood flow to the diseased lung. The mean percent of blood flow to the left lung in eight dogs with disease in that lung rose from 29% during air breathing to 32% (P < 0.001). In the second set of experiments, we measured apportionment of the blood flow between shunt pathways and gas-exchanging pathways by a constant infusion of radio-active krypton and the standard shunt formula. In eight dogs with bilateral disease, hypoxia consistently increased the flow through shunt pathways, from a mean value of 10% of pulmonary blood flow to 14% (P < 0.005).Thus, diffuse granulomatous disease causes a decreased vasoconstrictive response to hypoxia both in diseased, gas-exchanging regions and in shunt pathways. In proliferative interstitial pulmonary disease, generalized hypoxia causes shifts in pulmonary blood flow which do not ameliorate but rather worsen the hypoxemia of systemic arterial blood.
在两组针对健康犬的实验中，我们研究了弥漫性肉芽肿性肺病对肺循环低氧反应的影响。首先，在单侧患病动物中，将患病肺的血管收缩与对侧对照肺的血管收缩进行比较。其次，在双侧患病动物中，将肺分流途径的血管收缩与肺血管系统其他部分的血管收缩进行比较。在每项研究中，我们通过测量在呼吸21%和12%氧气期间测试血管组和对照血管组之间的肺血流分布来评估血管收缩。在第一组实验中，我们通过支气管肺量计和氪团注法测量两肺之间的血流分配。在正常犬中，低氧不会使血流有系统性地从一侧肺转移到另一侧。在10只单侧患病犬中，全身性低氧增加了流向患病肺的血流比例。在8只左肺患病犬中，呼吸空气时流向左肺的平均血流百分比从29%升至32%（P<0.001）。在第二组实验中，我们通过持续注入放射性氪和标准分流公式测量分流途径与气体交换途径之间的血流分配。在8只双侧患病犬中，低氧持续增加通过分流途径的血流，从肺血流平均值的10%增至14%（P<0.005）。因此，弥漫性肉芽肿性疾病导致患病的气体交换区域和分流途径对低氧的血管收缩反应降低。在增殖性间质性肺病中，全身性低氧导致肺血流转移，这不会改善反而会加重体循环动脉血的低氧血症。
