摘要
目的 探讨心脏手术血管麻痹综合征的机制。方法 将 2 4只白兔进行全身肝素化后静脉麻醉 ,分离肺动脉、肾动脉、颈动脉周围结缔组织 ,将动脉切成长为 3.0mm动脉血管环 ,将血管环随机分为 4组 ,每组 8只 ,即对照组 (常温组 ) :实验温度 37℃ ;实验 1组 :实验温度 30℃ ;实验 2组 :实验温度 2 4℃ ;实验 3组 :实验温度 16℃ (实验 1～ 3组均为低温组 )。将血管环放在 37℃的Kreb溶液中孵育 1h ,检验血管环内皮的完整性 ,抛弃内皮破坏的血管环。利用血管张力计算机软件记录不同温度下血管张力变化。测量低温对去甲肾上腺素的影响时 ,各组血管环继续在对应温度的Kreb溶液中孵育 30min ,依次从低浓度到高浓度加入人工合成去甲肾上腺素 ,低浓度去甲肾上腺素达到平衡后 ,依次加入高浓度去甲肾上腺素 ,依次记录每一浓度血管环张力。结果 各低温组与常温组相比 ,低温可引起肺动脉、肾动脉、颈动脉舒张 (F肺动脉 =6 9 90 9,F肾动脉 =131 192 ,F颈动脉 =5 0 6 6 3,P<0 0 0 1) ,并且能抑制去甲肾上腺素引起的肺动脉 (F =2 6 9 12 1,P <0 0 0 1)、肾动脉 (F =2 5 0 5 35 ,P <0 0 0 1)及颈动脉 (F =2 12 5 85 ,P <0 0 0 1)的收缩。结论 低温可能是心脏手术血管麻痹综合征的一个原因。
Objective To study the mechanism of vasoplegic syndrome after cardiac surgery. Methods Twenty four rabbits were anesthized intravenously. Pulmonary artery, renal artery, and carotid artery were isolated and arterial rings with the length of 3.0 mm, 8 rings for each artery, were resected and incubated in Kreb solution at temperature of 37℃ for one hour. The intactness of endothelium of arterial rings was examined. Those losing intactness were abandoned. The change of angiotasis at different temperatures was recorded with vascular tone software. The arterial rings of different groups were incubated in Kreb solution at the temperatures of 37℃, 30℃ and 24℃ for 30 minutes. Noradrenalin of different concentrations was added into the solution at different temperatures. And then the angiostasis was recorded. Results At low temperature, the vascular tone of the three arteries ( F pulmonary artery=69.909, F renal artery=131.192, F carotid artery=50.663, P <0.001) and contraction in response to noradrenline of pulmonary artery ( F =269.121, P <0.001), renal artery ( F =250.535, P <0.001) and carotid artery ( F =250.535, P <0.001) were lower than at normal temperature. Conclusion Hypothermia may be one of the causes of vasoplegic syndrome after cardiac surgery.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2002年第2期127-130,共4页
National Medical Journal of China
