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在正常和冠状动脉狭窄犬中扩张胃对冠脉血流动力学的影响

陈士良, 潘真, 朱妙章, 臧益民

第四军医大学生理学教研室

摘要

饱餐和扩张胃对心血管的影响早已引起人们的注意,但结论是不一致的。以往的实验都是在正常冠脉的动物上进行。该文在造成冠脉狭窄的情况下进行观察。在22条开胸狗的左旋支上,用微米狭窄器造成临界狭窄和重度狭窄。把一个气球送入胃中并充气600ml连续观察30min。正常冠脉组在扩张胃的最初15min内(前期)冠脉流量增多,主动脉压升高,血管总阻力下降,冠脉扩张;在扩张胃后15分钟(后期)无显著变化。冠脉临界狭窄组,前期冠脉流量增多,血管总阻力下降,冠脉扩张;后期流量减少,壁内血管阻力增加,冠脉收缩。冠脉重度狭窄组,前期冠脉流量无明显增加;后期流量显著减少,血管总阻力及心外膜、壁内务管阻力均增加,提示左旋支血管各段都发生收缩。

关键词： 胃扩张; 冠脉血流; 冠脉狭窄; 外周冠脉压; 冠脉阻力

The hemodynamic effect of distention of the stomach in dogs with normal and stenosed coronary artery

Chen Shiliang, Pan Zhen, Zhu Miaozhang, Zang Yimin

Department of Physiology, Fourth Military Medical College of PLA

Abstract

It has long been known that food intake or distention of the stomach affects cardiovascular function, but the conclusion remains controversial. Previous experiments were made on animals with normal coronary circulation. In this paper, the effect of distention of the stomach was studied in dogs with either normal or stenosed coronary artery. In 22 open-chest mongrel dogs, critical and severe stenosis were produced on left circumflex coronary artery (CX) with a micrometer constrictor. A large balloon was placed into the stomach and inflated with 600 ml of air. The postdistention effect was observed for 30 min. The response to distention of the stomach was biphasic. At the early stage of stomach distention in dogs with normal coronary artery, left circumflex coronary blood flow (Fcx) was increased, mean arterial pressure (Pa) rose, resistance of CX was reduced, and CX vasodilation occurred. All these changes recovered within a quarter to half an hour. In critical coronary stenosis, CX vasodilation occurred first, then followed by a decrease of Fcx, the resistance of distal vascular bed (R2) increased as a result of vasoconstriction. In severe coronary stenosis, at first Fcx was unchanged, but then decreased remarkably, R, R_(2) and the resistance of proximal segment (R_(1)) rose, CX vasoconstriction occurred. It is suggested that postprandial angina pectoris be due to a reduction in coronary blood flow on the basis of coronary stenosis.

Key words: Distention of stomach;Coronary blood flow;Coronary stenosis;Peripheral coronary pressure;Coronary vascular resistance

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引用本文：

陈士良, 潘真, 朱妙章, 臧益民. 在正常和冠状动脉狭窄犬中扩张胃对冠脉血流动力学的影响[J]. 生理学报 1986; 38 (3): .

Chen Shiliang, Pan Zhen, Zhu Miaozhang, Zang Yimin. The hemodynamic effect of distention of the stomach in dogs with normal and stenosed coronary artery. Acta Physiol Sin 1986; 38 (3): (in Chinese with English abstract).