α-人心房钠尿多肽对大鼠血流动力学的作用

本工作观察了α-人心房钠尿多肽(α-Human atrial natriuretic polypeptide,α-hANP)对麻醉大鼠的血流动力学作用。静脉注射α-hANP(3μg/100g)后,动脉血压(ABP)、左室内压(LVP)、左室 dp/dt(LV dp/dt)、心指数(CI)和总外周阻力指数(TPRI)均明显下降,而心率(HR)无明显变化。切断迷走神经后,α-hANP 降压和 LV dp/dt 下降的程度虽有所减小,但与切断前相比无统计学意义。我们的结果表明,α-hANP 对麻醉大鼠的降压机制,在于外周血管舒张所致的总外周阻力减小,以及心肌收缩性能抑制而引起的心输出量降低。     

家兔Bezold—Jarisch反射的血流动力学效应

在40只麻醉兔,观察经冠脉内注射尼古丁诱发Bezold-Jarisch反射时的血流动力学变化。反射效应表现为心率减慢、动脉血压和左心室收缩压降低以及左心室内压微分值减小。切断两侧窦神经和减压神经后,上述效应增强;两侧迷走神经切断后,多数动物反射效应消失。 冠脉内注射尼古丁后,心输出量和总外周阻力均下降。人工起搏心脏以防止心率减慢时,对上述效应无明显影响。动物阿托品化并切除两侧星状神经节后,心率减慢基本消失,但动脉血压降低的程度并无明显变化。结果提示,Bezold-Jarisch反射时所表现的动脉血压降低,可归因于心输出量减少和总外周阻力降低,而以后者为主。     

刺激家兔肾内感受器和肾传入神经的血流动力学效应

在39只麻醉家兔观察刺激肾脏机械和化学感受器以及电刺激肾传入神经的血流动力学效应。增加输尿管压8—22mmHg 及经输尿管向肾盂内逆向灌注 NaCl(1.0 mol/L)及 KCl(0.15mol/L)溶液时,引起平均动脉压(MAP)和心率(HR)下降;切断双侧缓冲神经后,MAP 降低更为显著。电刺激肾传入神经时,HR 减慢,MAP、肠系膜动脉和后肢动脉灌流压降低,左心室收缩压及其微分值下降,心输出量(CO)和总外周阻力(TPR)减小;切断双侧窦神经和减压神经后,除 HK、CO 和 TPR 外,其余各血流动力学指标的减弱更为显著。由此提示,动脉压力感受器反射对肾传入神经激活的心血管效应有缓冲作用。     

刺激腓深神经对低血压或休克狗心血管活动的影响

实验在麻醉狗中进行。静脉内匀速注射硝普钠时,平均动脉压和左心室收缩压明显降低,左心室dp/dt_(max)、-dp/dt_(max)和心力环面积均明显减小。此时电刺激一侧腓深神经可使动脉血压和左心室收缩压明显升高,dp/dt_(max)和心力环面积也显著增加。停止刺激后,动脉血压和左心室收缩压逐渐回向刺激前的水平。停止注射硝普钠5～15分钟后,上述各项观察指标基本恢复到注药前的水平。在用大肠杆菌内毒素造成休克的狗中,电刺激一侧腓深神经,也能使平均动脉压和左心室收缩压升高,同时dp/dt_(max)、-dp/dt_(max)和肠系膜血管阻力明显增高,但肾血管阻力增加不明显。本实验结果与以往的实验资料一起表明,在用扩血管药造成低血压时,躯体神经刺激引起的升压效应似乎以心肌收缩力增加为主;而在内毒素休克时,躯体神经刺激可通过改善心肌收缩功能和增加内脏血管阻力而引起升压作用。     

充胀犬胸部降主动脉所致的升压效应

在17只麻醉开胸犬,观察局部充胀胸部降主动脉(TDA)对心血管活动的影响。主要结果如下:1.充胀 TDA 引起心率、心肌收缩力、肾及股薄肌灌注压和全身动脉血压增加;TDA 局部去神经后反应消失,表明上述心血管效应系 TDA 受牵张刺激引起的正反馈性神经反射现象。2.切断动物两侧颈迷走神经和窦神经后,充胀 TDA 引起的心血管效应增大。3.用心得安(1mg/kg)消除心脏的β-效应后,充胀 TDA 引起的升压反应有所减小;用酚妥拉明(3mg/kg)阻断血管的α-受体效应后,多数动物即不再出现血压增高,从而提示充胀TDA 时的血压升高主要是反射性外周阻力增加所致。在缓冲神经完整的条件下,上述 TDA加压效应是存在的,但主动脉弓和颈动脉窦缓冲反射对其有对抗作用。     

兔颈动脉窦和主动脉弓压力感受器反射效应的比较研究

对81只麻醉兔,在静脉注射新福林和硝普钠升降血压而改变动脉压力感受器活动的条件下,观察心率,后肢血管阻力和肾交感神经活动的反射性变化。主要结果如下:(1) 由新福林升高血压时,心率减慢、后肢血管阻力降低和肾交感神经活动抑制;硝普钠降低血压时引起相反效应。各指标的反射性变化有良好的可重复性。(2) 切断两侧减压神经或切断两侧窦神经后,静注新福林和硝普钠诱发的心率反射性变化均显著减弱(P<0.01);切断两侧减压神经较切断两侧窦神经后减弱得更为明显,其中对于新福林升压时的心率减慢反应差异显著(P<(0.05)。相反,对于新福林和硝普钠引起的后肢血管阻力反射性变化,与缓冲神经部分切断之前相比无明显差异;在对照肾交感神经活动已增高的基础上,硝普钠降压时肾交感神经活动的反射性兴奋效应降低,而新福林升压时的肾交感神经活动反射性抑制效应与神经切断前相比无明显差异。(3) 缓冲神经全部切断(SAD)后,新福林和硝普钠引起的平均动脉血压(MAP)变动幅度显著增大(P<0.05)。此时心率、后肢血管阻力和肾交感神经活动的反射调节效应均明显减弱(P<0.001)。(4) 进一步切断两侧迷走神经后,残留的反射效应即行消失。 以上结果表明,颈动脉窦和主动脉弓压力感受器传入以单纯相加的方式对心率进行反射性调节,以主     

哈慈五行针治疗高血压的机理探讨

高血压的形成与调节机理心血管系统是由心脏、动脉、毛细血管及静脉组成的一个封闭的运输系统,由心脏的节律性收缩提供动力,推动血液在其中循环流动为机体提供赖以生存的物质,包括营养成分和氧气,并带走代谢产物和二氧化碳,以此协调整个机体的功能,因此将血压维持在正常水平是保证血液循环良好工作状态的必要条件。影响血压主要是二个因素：（血压＝心输出量×总外周阻力）心脏的机能状态：当交感神经兴奋或其他刺激引起心率加快,心室收缩力增强时,心输出量增加,相反迷走神经兴奋等因素可抑制心脏活动,心输出量降低。总外周阻力：…     

心房钠尿多肽对麻醉大鼠血压和肾神经传出放电的影响

本实验观察了心房肽Ⅱ(Atriopeptin Ⅱ,APⅡ)对麻醉大鼠血压(AP)、心率(HR)和肾交感神经传出放电(RSNA)的影响,并与硝普钠对 AP 和 RSNA 的影响作比较。结果如下:(1)缓冲神经完整和迷走神经完整条件下(n=12)静脉注射 APⅡ(50μg/kg)后,动脉收缩压(SAP)降低23.0±1.66 mmHg(Μ±SE,p<0.001),HR 减慢9±3.5b/min(p<0.05),RSNA 降低4.89±2.95%(P>0.05)。迷走神经切断后,静脉注射 APⅡ引起的~⊿SAP 虽有所减小,但与切断迷走神经前的反应比较,无统计学意义,HR 减慢不再出现,而 RSNA 则有所增加;(2)缓冲神经切断和迷走神经完整条件下(n=7),静脉注射 APⅡ时 SAP 降低27.4±3.25mmHg(P<0.001),HR 减慢13±3.1b/min(P<0.01),RSNA 降低11.67±1.95%(P<0.001)。切断迷走神经后,静脉注射 APⅡ引起的 SAP 降低程度有明显減小(P<0.01),HR减慢不再出现,RSNA 则反而增加(3)无论在迷走神经完整还是切断条件下,静脉注射硝普钠(n=6) SAP 均明显降低,同时伴有 RSNA 的反射性增加。以上结果表明:APⅡ的降压效应,部分是通过迷走神经传入纤维;在切断缓冲神经条件下,APⅡ可经由迷走神经传入纤维的激活而反射地抑制 RSNA。     

兔肾性高血压时的动脉压力感受器反射

14只雄性家兔在双肾缩扎术后12周,经氨基甲酸乙酯静脉麻醉,分别在缓冲神经完整、切断两侧减压神经或切断两侧窦神经后静注新福林或硝普钠升降血压以改变动脉压力感受器活动,观察其心率、后肢血管阻力和肾交感神经活动的反射性变化,并与正常血压兔的反射效应相比较。主要结果如下:(1) 动物双肾动脉缩扎后12周,平均动脉血压(131±9mmHg)较正常动物血压(95±10mmHg)有显著升高(P<0.001);(2) 缓冲神经完整时,新福林和硝普钠升降血压诱发的心率反射性变化与正常血压动物相比显著减弱(P<0.001),而后肢血管阻力和肾交感神经活动的反射性调节无明显改变,表明肾性高血压动物的心率反射性调节与外周循环的反射性调节机能不相平行;而由股动脉内直接注射新福林或硝普钠时,股动脉灌流压的增减幅度与正常血压动物相比并无明显差异;(3) 切断两侧减压神经或切断两侧窦神经后,在正常动物仅使反射性心率调节作用减弱,而后肢血管阻力和肾交感神经活动的反射性调节无明显改变;但在高血压动物,除心率的反射性调节进一步减弱外,新福林和硝普钠升降血压时后肢血管阻力和肾交感神经活动的反射性调节效应也显著地减弱(P<0.001),提示肾性高血压时动脉压力感受器反射的潜在调节能力降低。由此似表明,肾性高血压时动脉压力感受器反射     

家兔油酸型急性呼吸窘迫综合征时肺动脉血压的变化

本文介绍家兔油酸型呼吸窘迫综合征时肺动脉血压的变化。静脉注入油酸后,肺血管阻力显著增加,股动脉血压、心率和心输出量均下降;肺动脉压则升高,并经历最初快速升高、相对稳定和后期升高三个时相变化。预先注射神经节阻滞剂六甲双胺或α-受体阻断剂酚妥拉明,然后注射油酸,肺动脉压的最初快速升高期不出现。切断两侧颈动脉窦神经或两侧颈部迷走神经对其并无影响。此外,在后期,六甲双胺及酚妥拉明两者均不能阻断肺动脉压的上升。上述结果表明,动物注射油酸后,肺动脉压的最初快速升高是通过交感神经实现的。肺动脉压的后期升高则是缺氧或其他因素所造成。     

Acidaemia reduces cardiac output and left ventricular contractility in conscious lambs

We studied the effects of HCI-induced metabolic acidaemia on cardiac output, contractile function, myocardial blood flow, and myocardial oxygen consumption in nine unanaesthetized newborn lambs. Through a left thoracotomy, catheters were placed in the aorta, left atrium and coronary sinus. A pressure transducer was placed in the left ventricle. Three to four days after surgery, we measured cardiac output, dP/dt, left ventricular end diastolic and aortic mean blood pressures, heart rate, aortic and coronary sinus blood oxygen contents, and left ventricular myocardial blood flow during a control period, during metabolic acidaemia, and after the aortic pH was restored to normal. We calculated systemic vascular resistance, myocardial oxygen consumption and left ventricular work. Acidaemia was associated with reduction in cardiac output, maximal dP/dt, and aortic mean blood pressure. Left ventricular end diastolic pressure and systemic vascular resistance increased, and heart rate did not change significantly. The reduction in myocardial blood flow and oxygen consumption was accompanied by fall in cardiac work. Cardiac output returned to control levels after the pH had been normalized but maximal dP/dt was incompletely restored. Myocardial blood flow and oxygen consumption increased beyond control levels. This study demonstrates that HCI-induced metabolic acidaemia in conscious newborn lambs is associated with a reduction in cardiac output which could have been mediated by the reduction in contractile function and/or the increase in systemic vascular resistance. The decreases in myocardial blood flow and oxygen consumption appear to reflect diminished cardiac work. The restoration of a normal cardiac output after normalization of the pH appears to have resulted from the increases in heart rate and left ventricular filling pressures in conjunction with an incomplete restoration of contractile function.     

犬心右室,左室大面积梗塞时的容量负荷评价

在１２只犬,结扎四支冠脉,造成犬心右室、左室大面积梗塞和心源性休克时,左室收缩压（ＬＶＳＰ）及最大正负压力阶差（±ｄｐ／ｄｔｍａｘ．）分别下降５４％、５１％和４７％,而右室收缩压（ＲＶＳＰ）及±ｄｐ／ｄｔｍａｘ．仅降低９％、２５％和２７％。组Ⅰ（６只犬）快速扩容（低分子右旋糖酐３０ｍｌ／ｋｇ,２０ｍｉｎ内静脉输入）,结果右室反向搏动增强,双心室±ｄｐ／ｄｔｍａｘ．进一步降低,右房压（ＲＡＰ）及左室舒张末压（ＬＶＥＤＰ）极度升高达２．９±０．２ｋＰａ和５．０±０．３ｋＰａ（Ｐ均＜０．０１）,甚至诱发室颤。组Ⅱ缓慢静点多巴胺（１０μｇ／ｋｇ·ｍｉｎ）和硝酸甘油（１μｇ／ｋｇ·ｍｉｎ）３０ｍｉｎ,有效提高了动脉压（ＡＰ）,心输出量（ＣＯ）,ＬＶＳＰ及左室±ｄｐ／ｄｔｍａｘ．使休克逆转。结果表明,大面积左、右室梗塞伴休克时,右室残余心肌的代偿性收缩仍能造成ＲＶＳＰ与右室泵功能呈分离状态;此时快速扩容将进一步损害左、右室功能,而联合使用硝酸甘油和多巴胺能有效纠正休克同时不造成ＲＡＰ和ＬＶＥＤＰ的升高。     

急性低氧下钙阻断剂对左,右心泵功能的影响

在20条麻醉开胸狗上,用RM-6000多道仪同步记录左心室内峰压(LVP)、左室压力变化率(L+dP/dt_(max))、右心室内峰压(RVP)、右室压力变化率(R±dp/dt_(max))、肺动脉压力(P_(Pa))、主动脉血流每搏峰值(Fa)、心率(HR)等各项生理指标,观察钙通道阻断剂Nife-dipine,Diltiazem和Verapamil对左、右心室功能影响。在钙通道阻断剂处理后,左室的LVP,L±dp/dt_(max)下降,而Fa增加;右室的RVF,R±dp/dt_(max)和P_(Pa)均有升高趋势,显示钙通道阻断剂对左、右心泵功能的影响不同。这可能提示左、右心室功能对钙离子的依赖程度不同。在急性低氧状态下,此三种钙阻断剂均使急性低氧引起LVP的增加反应消失,Fa增加明显,Verapamil和Diltiazem有减轻急性低氧引起的RVP和P_(Pa)的增压作用。从这些钙通道阻断剂对左右心泵功能影响的比较来看,Diltiazem比Verapamil和Nifedipine对急性低氧状态下的心泵功能有较好的作用。     

Hemodynamic effects of procainamide and quinidine and the influence of beta-blockade before and after experimental myocardial infarction.

The use of antiarrhythmie drugs in combination has been limited because of possible side effects secondary to myocardial depression in the acute myocardial infarction patient. Therefore, we investigated in intact dogs (group I) the hemodynamic interaction of propranolol plus procainamide (subgroup A) or quinidine (subgroup B) and in dogs after experimental myocardial infarction produced by coronary artery ligation (group II). Infusion of procainamide (30 mg/kg over 5 min) in animals of group IA produced a significant (P less than 0.05) decrease of 30% in mean aortic pressure, a decrease of 40% in left ventricular dp/dt and 29% in cardiac output. When procainamide was reinfuse after propranolol (1 mg/kg), its hemodynamic effects were not significantly different from those observed before propranolol in both groups IA and IIA. Infusion of quinidine (10 mg/kg over 5 min) in animals of group IB (intact dogs) also produced significant decreases of 24% in mean aortic pressure and 38% in dp/dt while cardiac output was unchanged. However, these hemodynamic changes were seen only after beta-blockade and were significantly different from those obtained before propranolol, where heart rate increased by 14%, dp/dt by 30%, and cardiac output by 35%. These changes occurred despite a similar reduction in mean aortic pressure. This drug combination produced similar response in animals after coronary artery ligation (group IIB). In conclusion, we feel that the administration of propranolol does not prevent the depressive circulatory effects of procainamide. The combined use of quinidine and propranolol also has a negative circulatory effect although not as marked as the effects observed after procainamide with propranolol.     

Effect of methylene blue on cardiac output response to exercise in dogs

To determine whether the increase in cardiac output during mild to moderate exercise is related to an increase in the tissue redox potential, we compared the responses of cardiac output, total body oxygen consumption, and arterial blood lactate-to-pyruvate ratio (a measure of NADH/NAD) to treadmill exercise between dogs treated with normal saline and those treated with a hydrogen acceptor, new methylene blue. Normal saline was infused into the left atrium in the first group of dogs at a rate of 0.38 ml/min throughout the treadmill exercise (2.5 mph and 5.0 mph on a 6% incline, each for 20 min). In the second group, methylene blue was administered as a loading dose (4 mg/kg) before exercise, followed by a continuous infusion (0.15 mg X kg-1 X min-1) throughout exercise. A similar infusion of methylene blue was given to a third group of dogs without exercise; it reduced the arterial lactate-to-pyruvate ratio from 6.70 +/- 0.35 to 4.12 +/- 0.27 but had no or little effects on cardiac output, heart rate, arterial pressure, and left ventricular dP/dt and (dP/dt)/P. Treadmill exercise doubled cardiac output and increased total body O2 consumption three- to fourfold in the first two groups but increased arterial blood lactate-to-pyruvate ratio only in group 1 (6.0 +/- 0.54 to 9.97 +/- 0.91). The relationship between cardiac output and total body O2 consumption was unaffected by the simultaneous administration of methylene blue during exercise. Groups 1 and 2 also did not differ in their heart rate, left ventricular dP/dt and (dP/dt)/P, and plasma catecholamine responses to exercise.(ABSTRACT TRUNCATED AT 250 WORDS)     

Influence of vasoactive intestinal polypeptide (VIP) on splanchnic and central hemodynamics in healthy subjects

The influence of VIP, a potent vasodilator, on central hemodynamics, splanchnic blood flow and glucose metabolism was studied in six healthy subjects. Teflon catheters were inserted into an artery, a femoral vein and a right-sided hepatic vein. A Swan-Ganz catheter was introduced percutaneously and its tip placed in the pulmonary artery. Determinations of cardiac output, systemic, pulmonary arterial and hepatic venous pressures as well as splanchnic blood flow were made in the basal state and at the end of two consecutive 45 min periods of VIP infusion at 5 and 10 ng/kg/min, respectively. Arterial blood samples for analysis of glucose, FFA, insulin and glucagon were drawn at timed intervals. VIP infusion at 5 ng/kg/min resulted in an increase in cardiac output (55%) and heart rate (25%) as well as a reduction in mean systemic arterial pressure (15%) and vascular resistance (45%). With the higher rate of VIP infusion heart rate tended to rise further while cardiac output and arterial pressure remained unchanged. At 15 min after the end of VIP infusion the above variables had returned to basal levels. Splanchnic blood flow and free hepatic venous pressure did not change significantly. Arterial concentrations of glucose, FFA, insulin and glucagon increased during VIP infusion. At 15 min after the end of infusion the glucose levels were still significantly higher than basal (20%). Net splanchnic glucose output did not change in response to VIP infusion. It is concluded that VIP exerts a potent vasodilatory effect resulting in augmented cardiac output and lowered systemic blood pressure and vascular resistance.(ABSTRACT TRUNCATED AT 250 WORDS)     

Assessment of haemodynamic changes and acid-base equilibrium during hypovolaemia and after infusion of plasma substitutes in dogs

The following haemodynamic values were determined in anaesthetized mongrel dogs: heart rate, systolic blood pressure in the ascending aorta, left ventricular pressure at the peak dp/dt, left ventricular end-diastolic pressure, time interval from Q in ECG to the onset of the systolic wave of dp/dt, time interval from Q in ECG to peak dp/dt, maximum rate of left ventricular pressure rise, femoral arterial flow, and certain indices of left ventricular contractility. It was concluded from the results of these experiments that infusion of a modified gelatin solution Fluigel prevented haemodynamic and metabolic changes produced by experimental hypovolaemia more effectively than infusion of Plasmagel.     

卡托普利对实验性2型糖尿病心肌病大鼠模型心脏保护作用

目的研究卡托普利对实验性2型糖尿病心肌病（T2DC）模型动物心脏保护作用和可能机制。方法以高糖脂饲料负荷30mg／kg剂量链脲佐菌素一次性腹腔注射建立T2DC大鼠模型,观察卡托普利45mg／kg灌胃给药6周对模型动物血糖和血脂水平,心脏功能和结构变化,心肌脂肪酸含量以及心肌组织过氧化物增殖体激活受体α（PPAR）和葡萄糖转运体4（GLUT4）基因表达等指标的影响。结果与T2DC大鼠模型比较,卡托普利给药后,左心室收缩压、左心室最大收缩速率、左心室最大舒张速率的绝对值和心输出量分别显著增加15％、77％、52％和54％（P〈0．05或P〈0．01）;室间隔厚度降低40％（P〈0．001）;血浆糖化血红蛋白和心肌组织游离脂肪酸含量分别降低31％和24％（P〈0．01,P〈0．05）;心肌组织PPARα基因表达显著降低（P〈0．05）,GLUT4基因表达显著增加（P〈0．05）。结论卡托普利可以显著改善T2DC模型动物心脏功能、抑制心室重构,其作用机制可能同调节与能量代谢相关基因表达、减轻心脏内脂肪积聚有关。