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目的 :通过观察电刺激等长收缩运动 (IE)及正压呼吸时肺内压对肺毛细血管楔嵌压 (PCWP)的影响 ,探讨IE时PCWP增加的机理。方法 :成年健康杂种犬 5只 (雌性 2只 ,雄性 3只 ) ,体重 11.1± 1.0kg。浅麻醉下以感应电刺激使腓肠肌产生最大IE ,并以呼吸器向肺内充气产生正压呼吸。腓肠肌单侧电刺激IE9分钟、双侧电刺激IE9分钟、正压呼吸时肺内压为 2kPa、3kPa、4kPa、5kPa时以及安静状态测定PCWP。结果 :(1)单侧和双侧腓肠肌电刺激IE时的PCWP与安静状态相比无显著差异 (p >0 .0 5 ) ,两种IE之间比较亦无显著差异 (p>0 .0 5 ) ;(2 )肺内压与PCWP相关系数为 0 .89(p <0 .0 1)。结论 :IE本身不直接引起PCWP增高 ,肺内压增高与PCWP增加直接相关 ,因此高强度IE合并的乏氏动作可能是引起PCWP生理性增高的机理之一。
OBJECTIVE: To investigate the effects of electrical stimulation of isometric contraction (IE) and pulmonary pressure on pulmonary capillary wedge pressure (PCWP) during positive pressure respiration and to explore the mechanism of PCWP increase in IE. Methods: Five adult healthy mongrel dogs (2 females and 3 males) weighing 11.1 ± 1.0 kg were used. Shallow anesthesia to induce electrical stimulation of the gastrocnemius to produce maximum IE, and breathing to the lungs to produce positive pressure breathing. Gastrocnemius muscle unilateral electrical stimulation IE9 minutes, bilateral electrical stimulation IE9 minutes, positive pressure breathing pulmonary pressure 2kPa, 3kPa, 4kPa, 5kPa and measured PCWP quiet state. Results: (1) PCWP in unilateral and bilateral gastrocnemius stimulation was not significantly different from resting state (p> 0.05), there was no significant difference between the two IEs (p> 0. 0 5); (2) The correlation coefficient between intrapulmonary pressure and PCWP was 0.89 (p <0.01). CONCLUSION: IE itself does not directly cause increased PCWP. The increased intrapulmonary pressure is directly related to the increase of PCWP. Therefore, the combination of high-intensity IE and fatigue may be one of the mechanisms leading to the physiological increase of PCWP.