体外循環によって引き起こされる低血圧:ポンプで活性化された血小板からのセロトニンは,酸化窒素の放出を誘発する
Piet Borgdorff1, Durk Fekkes, Geert Jan Tangelder
1Laboratory for Physiology, Institute for Cardiovascular Research, Vrije Universiteit Medical Center, Amsterdam, The Netherlands. p.borgdorff.physiol@med.vu.nl
Circulation
|November 13, 2002
まとめ
ポンプ誘発の血小板活性化は,酸化窒素の放出と血管拡張を誘発するセロトニンを放出することによって,心肺バイパスと血液透析の間に低血圧を引き起こす.
科学分野:
- 心血管生理学 心血管の生理学
- ヘモダイナミクスは,
- 血小板生物学 血小板生物学について
背景:
- 心肺バイパスと血液透析は低血圧の原因として知られています.
- 根本的なメカニズム,特にポンプによる影響については,さらなる調査が必要である.
研究 の 目的:
- ポンプ誘発の血小板活性化とセロトニンの放出が,体外循環中の低血圧を引き起こす役割を調査する.
- ポンプによる血液動力学的変化に関与するシグナル伝達経路を解明する.
主な方法:
- ネズミの体外シャントは,ポンプ perfusion と autoperfusion のために確立されました.
- 血液動力学的パラメータ (大動脈圧,股関節抵抗) と血のセロトニン濃度がモニタリングされました.
- 血小板凝集,セロトニン,5-ヒドロキシトリプタミン (5-HT) 2受容体阻害,酸化窒素 (NO) 阻害の効果を評価した.
主要な成果:
- ポンプによる輸血は,自己輸血とは異なり,血小板の大幅な集積を引き起こし,大動脈圧の急速な低下を引き起こした.
- 低血圧と変異した股関節抵抗は,ポンプの下流の血セロトニン濃度の上昇と相関しています.
- 5-HT2受容体の遮断またはNO生成の抑制は,観察された血液動力学的変化を減弱または防止しました.
結論:
- 動脈リターンによるポンプ輸液は,血小板の活性化とセロトニンの放出を誘発する.
- セロトニンは,5-HT2受容体によって活性化される内皮酸化窒素 (NO) の放出を通じて低血圧を媒介する.
- これらの発見は,体外の処置中に低血圧に寄与するメカニズムを強調しています.
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