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心源性和非心源性肺水肿对绵羊组胺反应性的影响。

Effect of cardiogenic and noncardiogenic pulmonary edema on histamine responsiveness in sheep.

作者信息

Snapper J R, Lefferts P L, Lu W, Hwang Y S, Plitman J D

机构信息

Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-2650, USA.

出版信息

J Appl Physiol (1985). 1998 Nov;85(5):1635-42. doi: 10.1152/jappl.1998.85.5.1635.

Abstract

We compared the effects of cardiogenic pulmonary edema, brief pulmonary vascular congestion without frank edema, and noncardiogenic pulmonary edema on responsiveness to inhaled histamine in chronically instrumented awake sheep. Histamine responsiveness was measured before and after 1) cardiogenic pulmonary edema induced by raising left atrial pressure to 35 cmH2O (Pla) for 3.5 h by partial obstruction of flow across the mitral valve, 2) brief cardiogenic congestion via Pla for 0.5 h, 3) noncardiogenic pulmonary edema induced by 25 mg/kg intravenous perilla ketone (PK), and 4) 3.5 h of monitoring without Pla or PK (controls). Treatment for 3.5 h with Pla (n = 9) and PK (n = 11) each significantly lessened the histamine dose required to cause a fall to 65% of baseline dynamic lung compliance (ED65Cdyn), i.e., increased responsiveness. Sheep treated for 0.5 h with Pla (n = 7) and controls (n = 5) showed no significant change in ED65Cdyn. Intravenous atropine (0.1 mg/kg) before the second histamine challenge altered neither the reduction of ED65Cdyn in Pla (n = 8) and PK (n = 9) sheep nor the ED65Cdyn level of controls (n = 9). These data imply that the local effects of edema, rather than bronchial vascular hemodynamics, cholinergic reflexes, and permeability changes, are germane to lung hyperresponsiveness during pulmonary edema in sheep.

摘要

我们比较了心源性肺水肿、无明显水肿的短暂肺血管充血以及非心源性肺水肿对长期植入仪器的清醒绵羊吸入组胺反应性的影响。在以下情况前后测量组胺反应性:1)通过部分阻断二尖瓣血流将左心房压力升至35 cmH2O(Pla)3.5小时诱导的心源性肺水肿;2)通过Pla进行0.5小时的短暂心源性充血;3)静脉注射25 mg/kg紫苏酮(PK)诱导的非心源性肺水肿;4)不使用Pla或PK进行3.5小时监测(对照组)。用Pla(n = 9)和PK(n = 11)分别治疗3.5小时均显著降低了使动态肺顺应性降至基线的65%所需的组胺剂量(ED65Cdyn),即反应性增加。用Pla治疗0.5小时的绵羊(n = 7)和对照组(n = 5)的ED65Cdyn无显著变化。在第二次组胺激发前静脉注射阿托品(0.1 mg/kg),既未改变Pla组(n = 8)和PK组(n = 9)绵羊ED65Cdyn的降低,也未改变对照组(n = 9)的ED65Cdyn水平。这些数据表明,在绵羊肺水肿期间,水肿的局部作用而非支气管血管血流动力学、胆碱能反射和通透性变化与肺高反应性相关。

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