低浓度去甲肾上腺素对局部血液循环影响的实验研究

目的:探讨低浓度去甲肾上腺素对局部血液循环的作用机理、影响,以及应用本实验诱导的滑膜炎动物模型进行髋关节一过性滑膜炎的相关研究,探讨去甲肾上腺素在髋关节一过性滑膜炎的发病机理中的作用。方法:40只2～3个月大小的幼狗随机分为10组,分别在每组动物髋关节内注入0.1‰、0.2‰、0.3‰、0.4‰、0.5‰、1‰、1.5‰、2‰、2.5‰、3‰的去甲肾上腺素,在不同时间用锝一亚甲基二磷酸盐(99mTc-MDP)三相骨显像,观察股骨头局部循环血流变化,同时测定关节内压变化,X线照片、B超检查及行病理组织学检查。另外,30只2～3月龄的幼狗随机分为3组,在髋关节内注入2‰去甲肾上腺素,在不同时间用锝一亚甲基二磷酸盐三相骨显像,观察股骨头局部循环血流变化,同时测定关节内压变化、病理组织学检查,观察整个髋关节引起的病理变化及发展过程。结果:不同浓度的去甲肾上腺素注入关节腔内后产生局部血管短暂收缩,血流量有不同程度的下降,局部血循环受到影响。NA达到2‰或以上时,血管短暂收缩明显,3小时后小血管扩张、充血、滑膜水肿,关节渗出,关节内压升高,血流量下降,局部血循环明显受阻,持续14天左右,28天后逐渐恢复正常。整个过程表现与髋关节一过性滑膜炎临床表现极为相似。结论:不同低浓度去甲肾上腺素可引起小血管扩张,局部血流量下降,NA达到一定浓度小血管扩张后出现充血、滑膜水肿,从而关节内压升高,股骨头出现局部短暂缺血,这种炎症反应和髋关节一过性滑膜炎的临床表现很相似。一定低浓度去甲肾上腺素在髋关节一过性滑膜炎发病机理中起重要的作用。临床上局部注射去甲肾上腺素应注意到其对局部血循环的影响从而带来的治疗影响。

Objective：To study the low concentration norepinephrine local blood circulation to the mechanism,effect of application,and the experiment of the synovial infection induced animal model for hip of synovial related research,discusses the effects of norepinephrine in hip of synovial of inflammation of the role of the mechanism.Methods：40 only 3 months of the size of the young dog randomly divided into 10 group respectively in each group of animals,in 0.1‰,hip into 0.2‰,0.3‰,0.4‰,0.5‰,1‰,1.5‰,2‰,2.5‰,3‰,of norepinephrine in different time,with at a and methyl phosphate（2 99 mTc-MDP） three-phase bone imaging,observe local blood circulation femoral head of change,at the same time determination within the joint pressure change,X-Ray photos,B ultrasonic examination and line histologic examination.In addition,30 only 3 months of young dog random into three groups,in the hip to infuse 2‰ norepinephrine,in different time to be with a methylene two phosphate three-phase bone imaging,observe local blood circulation femoral head of change,at the same time determination within the joint pressure change,histologic examination,observing the whole hip cause the pathological changes of the and developing process.Results：Different concentrations of norepinephrine into joint cavity produced after local vascular contraction,the blood flow is a different degree of decline,making 2‰ or above to,obviously,a short vascular contraction after 3 hours small vessel expansion,reddening,synovial edema,joint oozy,intra-articular pressure,blood flow down for two weeks or so,and four weeks after return to normal gradually,no synovial,avascular necrosis.The whole process performance and hip of synovial inflammation is very similar clinical manifestations.Conclusion：Different low concentration norepinephrine can cause small blood vessels,local blood flow down to a certain concentration,making small blood vessels appear after hyperemia,synovial oedema,joint exudate,joint internal pressure rise of femoral head to local produce and hip,ischemia of synovial inflammation is very similar clinical manifestations of inflammatory reaction.Certain low concentration norepinephrine in hip of inflammatory pathogenesis synovial plays an important role.