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长时间输注17β-雌二醇期间的全身及子宫血流分布

Systemic and uterine blood flow distribution during prolonged infusion of 17beta-estradiol.

作者信息

Magness R R, Phernetton T M, Zheng J

机构信息

Department of Obstetrics and Gynecology, Perinatal Research Laboratories, University of Wisconsin-Madison, Madison, Wisconsin 53715, USA.

出版信息

Am J Physiol. 1998 Sep;275(3):H731-43. doi: 10.1152/ajpheart.1998.275.3.H731.

Abstract

Prolonged 17beta-estradiol (E2beta) infusion decreases mean arterial pressure (MAP) and systemic vascular resistance (SVR) while increasing heart rate (HR) and cardiac output (CO). It is unclear, however, which systemic vascular beds show increases in perfusion. The purpose of this study was to determine which reproductive and nonreproductive vascular beds exhibit alterations in vascular resistance and blood flow during prolonged E2beta infusion. Nonpregnant, ovariectomized sheep received either vehicle (n = 6) or E2beta (5 microg/kg iv bolus followed by 6 microg/kg over 24 h for 10 days; n = 9), and blood flow distribution was evaluated using radiolabeled microspheres at control and 120 min and 3, 6, 8, and 10 days of infusion. During E2beta infusion MAP (87 +/- 5 mmHg; mean +/- SE) decreased 3-9% and HR (83 +/- 5 beats/min) increased 4-31%. The combined baseline (control) perfusion to the uterus, broad ligament, oviducts, cervix, vagina, and mammary gland (reproductive blood flows) was 49 +/- 9 ml/min; at 120 min, E2beta increased flow (P < 0.001) to 605 +/- 74 ml/min (1,263%) and it remained elevated, but at a reduced rate, on day 3 (218 +/- 44 ml/min; 399%), day 6 (144 +/- 23; 217%), day 8 (181 +/- 19; 321%), and day 10 (204 +/- 48; 454%), accounting for only 3-17% of the E2beta-induced increase in CO. During this E2beta treatment, there also were significant decreases in vascular resistances leading to increases (P < 0.05) in blood flows to several nonreproductive (systemic) vascular beds including skin (32-113%), coronary (32-190%), skeletal muscle (25-133%), brain (21-292%), bladder (128-524%), spleen (87-180%), and pancreas (35-137%) vascular beds. Responses of these combined nonreproductive blood flows represent the major percentage (21-67%) of the E2beta-induced increase in CO. Vehicle infusion was without effect. We conclude that prolonged E2beta infusion increases reproductive and nonreproductive tissue blood flows. The latter appears to principally be responsible for the observed rise in CO and decrease in SVR.

摘要

长期输注17β-雌二醇(E2β)可降低平均动脉压(MAP)和全身血管阻力(SVR),同时增加心率(HR)和心输出量(CO)。然而,尚不清楚哪些全身血管床的灌注会增加。本研究的目的是确定在长期输注E2β期间,哪些生殖和非生殖血管床的血管阻力和血流会发生改变。未怀孕的去卵巢绵羊接受载体(n = 6)或E2β(静脉推注5μg/kg,随后在24小时内以6μg/kg持续输注10天;n = 9),并在对照期以及输注的120分钟、3天、6天、8天和10天使用放射性微球评估血流分布。在输注E2β期间,MAP(87±5 mmHg;平均值±标准误)降低了3 - 9%,HR(83±5次/分钟)增加了4 - 31%。子宫、阔韧带、输卵管、子宫颈、阴道和乳腺(生殖血流)的联合基线(对照)灌注为49±9 ml/分钟;在120分钟时,E2β使血流增加(P < 0.001)至605±74 ml/分钟(增加了1263%),并且在第3天(218±44 ml/分钟;增加了399%)、第6天(144±23;增加了217%)、第8天(181±19;增加了321%)和第10天(204±48;增加了454%)仍保持升高,但速率降低,其增加量仅占E2β诱导的CO增加量的3 - 17%。在该E2β治疗期间,导致包括皮肤(32 - 113%)、冠状动脉(32 - 190%)、骨骼肌(25 - 133%)、脑(21 - 292%)、膀胱(128 - 524%)、脾脏(87 - 180%)和胰腺(35 - 137%)血管床在内的几个非生殖(全身)血管床血流增加(P < 0.05)的血管阻力也显著降低。这些联合的非生殖血流反应占E2β诱导的CO增加量的主要比例(21 - 67%)。输注载体没有效果。我们得出结论,长期输注E2β可增加生殖和非生殖组织的血流。后者似乎是观察到的CO升高和SVR降低的主要原因。

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