白介素-2诱发低血压动物的实验研究

白介素－２（ＩＬ－２）广泛用于治疗恶性肿瘤,由于大剂量可引起严重的低血压且机制不明,限制了其大剂量的使用。本研究用国产重组人白介素－２（ｒｈＩＬ－２）复制大鼠低血压模型并探讨其机制。２４只ｗｉｓｔａｒ大鼠随机分成３组（每组ｎ＝８）：正常对照组,ＩＬ－２实验组（ｒｈＩＬ－２）和氨基胍（ＡＧ）治疗组。结果显示：（１）ＩＬ－２可使大鼠提睾肌微动脉扩张及ＭＡＰ下降,肺、肾、肝组织Ｅｖａｎ′ｓＢｌｕｅ含量明显增加。（２）ＡＧ可使ｒｈＩＬ－２引起的低血压回升及微动脉缩小,肺组织Ｅｖａｎ′ｓＢｌｕｅ含量明显下降。提示：ｒｈＩＬ－２引起低血压,可能与ＩＬ－２诱导ＮＯ产生,使血管扩张及通透性增加有关。     

Stanniectomy attenuates the renin–angiotensin response to hypovolemic hypotension in freshwater eels (<Emphasis Type="Italic">Anguilla rostrata</Emphasis>) but not blood pressure recovery

Plasma Angiotensin II (ANG II) concentrations were measured in SHM (sham-operated 2 weeks) and CSX (corpuscles of Stannius removed 2 weeks) eels before and after the induction of hypovolemic hypotension (HH) by the rapid withdrawal of 8 ml kg bw⁻¹ of caudal venous blood. Baseline (before exsanguination) plasma ANG II concentrations were similar in SHM and CSX eels (81.3 ± 18.8 fmol ml⁻¹ cf. 106 ± 31.6 fmol ml⁻¹, respectively) but the elevation in plasma ANG II following HH (1,732 ± 82 fmol ml⁻¹) was attenuated by CSX (368 ± 127 fmol ml⁻¹) showing that the CS are linked to plasma ANG II concentrations. Plasma ANG II in both groups returned to baseline levels within 48 h. Dorsal aortic blood pressures (DABP) were measured in both experimental groups before, and during the 60 min after, blood withdrawal. A 44% decrease in mean DABP was observed in both SHM and CSX eels within 2 min and followed by similar rapid patterns of recovery of systolic, diastolic, and pulse pressures in both groups during the next 60 min showing that short-term recovery of DABP is not CS-dependent. Stanniectomy increased plasma Ca and K⁺ and decreased plasma Mg, Na⁺, Cl⁻ and osmolality which confirms some earlier observations in eels and other freshwater teleosts.     

ACE activity during the hypotension produced by standardized aqueous extract of Cecropia glaziovii Sneth: A comparative study to captopril effects in rats

To evaluate the effect of the standardized aqueous extract (AE) of Cecropia glaziovii Sneth on the plasma angiotensin I converting enzyme (ACE-EC 3.4.15.1) activity, rats were treated with a single dose of AE (1 g/kg, p.o.) or repeatedly (0.5 g/kg/bid, p.o.) for 60 days. Captopril (50 mg/kg, p.o.) was used as positive control on the same animals. The effects on the blood pressure were recorded directly from the femoral artery (single dose), or indirectly by the tail cuff method (repeated doses) in conscious rats. The plasma ACE activity was determined spectrofluorimetrically using Hypuril-Hystidine-Leucine as substrate. The arterial blood pressure, heart rate and plasma ACE activity were not significantly modified within 24 h after a single dose administration of AE. Comparatively, blood pressure in captopril treated rats was reduced by 7-16% and heart rate was increased by 10-20% from 30 min to 24 h after drug administration. ACE activity after captopril presented a dual response: an immediate inhibition peaking at 30 min and a slow reversal to 32% up-regulation after 24 h. To correlate the drug effects upon repeated administration of either compound, normotensive rats were separated in three groups: animals with high ACE (48.8+/-2.6 nmol/min/ml), intermediate ACE (39.4+/-1.4 nmol/min/ml) and low ACE (23.5+/-0.6 nmol/min/ml) activity, significantly different among them. Repeated treatment with AE reduced the mean systolic blood pressure (121.7+/-0.5 mm Hg) by 20 mm Hg after 14 days. The hypotension was reversed upon washout 60 days afterwards. Likely, repeated captopril administration decreased blood pressure by 20 mm Hg throughout treatment in all groups. After 30 days treatment with AE (0.5 g/kg/bid, p.o.) the plasma ACE activity was unchanged in any experimental group. After captopril (50 mg/kg/bid, p.o.) administration the plasma ACE activity was inhibited by 50% within 1 h treatment but it was up-regulated by 120% after 12 h in all groups. It is concluded that the hypotension produced by prolonged treatment with AE of C. glaziovii is unrelated to ACE inhibition.     

麻醉诱导时血压下降对术后恶心呕吐的影响

目的：观察麻醉诱导时血压下降与术后恶心呕吐的关系.方法：选择ASAⅠ-Ⅱ级的经腹胆囊切除术患者40例,按麻醉诱导时血压比基础值下降的程度分为2组,每组20例.A组：SBP比基础血压下降〉30%;B组：SBP比基础血压下降〈30%.术后随访病人48小时,记录病人恶心呕吐的发生情况.结果：麻醉诱导时血压下降对术后恶心呕吐有明显影响.结论：麻醉期间维持血流动力学稳定能降低PONV的发生.     

重组人脑利钠肽联合多巴胺对心肾综合征伴低血压的疗效及对血清NT-proBNP水平的影响

目的:研究重组人脑利钠肽联合多巴胺对心肾综合征伴低血压的疗效及对血清NT-proBNP水平的影响。方法:收集2015年4月至2016年4月我院的90例心肾综合征伴低血压患者,按抽签法分为实验组和对照组,每组45例。对照组用多巴胺治疗,实验组在对照组基础上加用重组人脑利钠肽。观察两组治疗疗效,治疗前后血压、心率、心动图指标每搏输出量(SV)、左心室射血分数(LVEF)、左心室舒张末内径(LVEDD),N末端前体脑钠肽(NT-proBNP)、血肌酐(SCr)、胱抑素C(Cys C)水平的变化。结果:治疗后,实验组总有效率为93.33%,显著高于对照组(68.88%,P0.05);SBP、DBP、MAP、SV、LVEF均显著高于对照组(P0.05),HR、血清NT-proBNP、SCr水平显著低于对照组(P0.05);两组LVEDD比较差异无统计学意义(P0.05)。结论:重组人脑利钠肽联合多巴胺对心肾综合征伴低血压的疗效显著,可缓解心脏负荷,改善心肾功能,降低NT-proBNP水平,提高治疗安全性。     

Hypotension with intravenous immunoglobulin therapy: importance of pH and dimer formation

Therapy with intravenous immunoglobulin preparations has been used effectively in a wide range of conditions. Although generally well tolerated, intravenous immunoglobulin preparations may be associated with transient hypotension in some patients. This study examined the role of different immunoglobulin G fractions in the development of intravenous immunoglobulin-induced hypotension in an anaesthetized rat model and assessed the effects of a new liquid immunoglobulin prepared at a low pH on both the formation of immunoglobulin G dimers and the development of hypotension. The effects of this new preparation in an experimental autoimmune encephalomyelitis model were also evaluated.Results from the haemodynamic studies indicated that immunoglobulin G dimers in polyclonal immunoglobulin G are responsible for the hypotensive events associated with some immunoglobulin preparations. They also showed that adjustment to an acidic pH results in the rapid dissociation of immunoglobulin G dimers and prevents the development of hypotension. Additional experiments demonstrated that only immunoglobulin G dimers with a functional Fc fragment can bind to Fcgamma receptors on macrophages to induce the release of blood pressure-lowering mediators. Moreover, essentially monomeric Fc fragments can block the blood pressure-lowering effects of immunoglobulin G dimers.Preparation of a new liquid intravenous immunoglobulin with the pH adjusted to 4.3 prevents the formation of immunoglobulin G dimers even over long-term storage and does not significantly affect blood pressure in a rat model. This preparation is as effective as other intravenous immunoglobulin preparations in ameliorating symptoms of experimental autoimmune encephalomyelitis. These results, like those from previous studies, indicate that preparation of intravenous immunoglobulin at a low pH substantially reduces immunoglobulin G dimerization; this effect significantly decreases the potential for intravenous immunoglobulin to induce hypotension without reducing its clinically relevant biological activity.     

Vasopressin: An essential pressor factor for blood pressure recovery following hemorrhage

Two experimental approaches were used to evaluate the importance of the pressor effects of vasopressin in blood pressure recovery following hypotensive hemorrhage. Experiments using homozygous Brattleboro rats demonstrated that the hemodynamic recovery of these animals was subnormal, even though the activation and efficacy of the sympathetic nervous and renin-angiotensin systems were intact. Experiments using an antipressor vasopressin analogue in normal rats during hypotensive hemorrhage demonstrated significantly blunted blood pressure recovery in the presence of the analogue. Thus, both experiments indicate that the pressor effects of circulating vasopressin play an essential role in blood pressure recovery following hypovolemic hypotension induced by hemorrhage.     

An angiotensin-I converting enzyme inhibitor from buckwheat (Fagopyrum esculentum Moench) flour

A compound that inhibited angiotensin-I converting enzyme (ACE) activity was isolated from buckwheat powder. This compound is thought to be the hydroxy derivative of nicotianamine and its chemical structure is 2'-hydroxynicotianamine. This compound showed a very high inhibitory activity toward ACE, and the IC(50) was 0.08 microM. Only this hydroxy analog was found in buckwheat powder, at about 30 mg/100g, and no nicotianamine was detected. However, nicotianamine was detected in the buckwheat plant body. 2'-hydroxynicotianamine was also found in other polygonaceous plants.     

Identification and partial characterization of immunoreactive and bioactive atrial natriuretic peptide from eel heart

Summary Cardiocytes positive for human atrial natriurectic peptide (hANP) were identified histochemically in the eel atrium, but they were not found in the ventricule. Secretory granules were frequently observed in atrial cardiocytes by electron microscopy, but the number of such granules was quite small in the ventricle. Immunogold cytochemistry revealed that immunoreactive ANP (IR-ANP) in atrial cardiocytes was localized in these granules. In spite of poor immunostaining of the eel ventricle, an acid extract of the ventricle contained 25±4 ng·g tissue^-1 (n=9) of IR-ANP when the level of IR-ANP was measured by radioimmunoassay (RIA) for hANP. This level was one eight of that measured in atrial extracts (203±13 ng·g tissue^-1, n=9). Plasma contained 116.7±18.6 pg·ml^-1 (n=9) of IR-ANP. An extract of eel hearts decreased arterial pressure in eels and quail as did hANP. The level of ANP in the extract, as measured by an eel vasodepressor bioassay, was much greater than that measured by RIA for hANP. The immunoreactive and bioactive ANP in the heart extract are identical since the vasodepressor activity disappeared after IR-ANP was absorbed by excess antibodies raised against hANP. Chromatography on Sephadex G-75 generated a major peak of IR-ANP at a position that corresponded to a molecular weight of 14 kD and minor peaks at 3–7 kD from both plasma and heart extract. Reverse phase HPLC of plasma and heart extract generated several peaks of IR-ANP at positions more hydrophilic than those of mammalian ANPs. These results show that eel hearts contain immunoreactive and bioactive ANPs which are distinctly different from hANP. These ANPs are synthesized both in the atrium and in the ventricle, and they are secreted into the circulation mostly in the larger molecular form. The atrial ANP may be stored in the granules and secreted upon exposure of eels to certain stimuli, but the ventricular ANP may be secreted constitutively into the circulation without prior storage in the granules.Abbreviations ANP atrial natriuretic peptide - BSA bovine serum albumin - IR-ANP immunoreactive ANP - PBS phosphate-buffered saline - RIA radioimmunoassay