急性大量饮酒对犬血流动力学和心肌力学的影响

目的　探讨急性大量饮酒对犬血流动力学和心肌力学的影响。方法　选用健康犬 10只 ,应用心导管技术观察急性大量饮酒 ( 2 g/kg酒精 )后犬血流动力学和心肌力学各项参数的变化以及血浆肾上腺素 ( AD)、去甲肾上腺素( NE)、肾素活性 ( RNA)、血管紧张素 ( AT- )和动脉血气的变化 ,进行自身对照研究。结果　急性大量饮酒后 ,心率加快 ,心排血量下降 ,平均肺动脉压升高 ,外周动脉收缩压下降、舒张压升高 ,左心室收缩压下降、舒张末压增高 ( P<0 .0 1或 P<0 .0 5 ) ;左心室压力最大上升速率和下降速率、心肌收缩因子缩短最大速度均下降 ,等容舒张期左心室压力下降时间常数延长 ( P<0 .0 1) ;血浆 AD、NE、RNA和 AT- 水平升高 ( P<0 .0 1或 P<0 .0 5 ) ;动脉血p H值、Pa O2 下降 ,Pa CO2 上升 ( P<0 .0 1)。结论　犬急性大量饮酒引起心脏整体泵血功能下降 ,左心室收缩和舒张功能下降 ,交感 -肾上腺髓质系统和肾素 -血管紧张素系统活动增强 ;交感神经兴奋效应不足以代偿酒精及其代谢产物对心肌毒性作用所引起的心室收缩和舒张功能的下降

Effects of acute large amounts of alcohol ingestion on hemodynamics and myocardial mechanics in dogs

Objective To investigate the effects of acute large amounts of alcohol ingestion on hemodynamics and myocardial mechanics in dogs. Methods In ten healthy dogs, cardiac catheter technique was used to measure the changes of hemodynamic parameters and myocardial mechanical parameters before alcohol(2g /kg body weight) ingestion and 0.5h, 1h, 1.5h, 2.5h after alcohol ingestion respectively. At the same time, the plasma levels of adrenalin(AD), norepinephrine(NE), renin activity(RNA), angiotensin Ⅱ(AT Ⅱ)and artery blood gas were assayed. Results After alcohol ingestion, left ventricular systolic pressure, artery systolic pressure and cardiac output were decreased( P <0.01); Heart rate ( P <0.05), left ventricular end diastolic pressure, artery diastolic pressure and mean pulmonary artery pressure were increased ( P <0.01). The first derivative of left ventricle (±dp/dt), the maximal velocity of shortening of the contractile element (Vmax) were decreased, and the time constant of left ventricle pressure fall during isovolumic relaxation (T) was lengthened ( P <0.01). The plasma levels of AD,RNA ( P <0.05), NE, and AT Ⅱ( P <0.01) were rised. pH and PaO 2 were decreased and PaCO 2 was increased ( P <0.01). Conclusions Acute large amounts of alcohol ingestion in dog decreased global systolic function and both of the left ventricular systolic and diastolic function; Alcohol interfered with sympath oadrenomedullary system and renal renin angiotensin system, which couldn't compensate the toxic effects of alcohol and it's metabolite on the cardiac muscle.