A Scintiphotographic Study of Pulmonary Edema and Hemorrhage Induced by Cerebral Compression and Norepinephrine

腦部壓迫及無甲基腎上腺素引起肺水腫及出血之閃爍造影

陳幸一(H. I. Chen) ； 施維貞(W. J. Shih) ； 陳通保(T. P. Chen)

《The Chinese Journal of Physiology》 22卷2期 (1976/12) Pp. 65-72

摘要

在麻醉後之大白鼠，壓迫腦部及注射無甲基腎上腺素產生一連串之血流動力變化而造成肺水腫及出血，利用核子醫學之閃爍造影研究其肺部血量的變化。本實驗採用Indium-113m同位素，此種同位素與血漿中之Transferrin（分子量90,000）結合成大分子之複合體，因此經靜脈注射後，此同位素局限於血管之內，隨血液而分佈全身。因心臟每單位體積含較多的血量，故在正常之閃爍造影圖片中，顯示具較多之放射度，肺臟本身之放射度甚小。動物經壓迫腦部或注射無甲基腎上腺素而產生肺水腫及出血之同時，閃爍影片顯示肺臟之放射度顯著增加，表示肺循環血量增多。本實驗所得之結果與先前研究之觀察所得一致，均顯示腦部壓迫及無甲基腎上腺素造成全身血管收縮，將大量的血液由體循環移積於肺循環，引發肺循環高血壓而導致肺水腫及出血。再者，此種閃爍造影法迅速而簡便，具有診斷價値，如能完成進一步之定量分析及應用試驗，其臨床使用似可預期。

並列摘要

Chen, H. I., W. J. Shih, and T. P. Chen. A scintiphotographic study of pulmonary edema and hemorrhage induced by cerebral compression and norepinephrine. Chinese J. Physiol., 22(2): 65-72, 1976.-Pulmonary edema and hemorrhage (PEH) was induced in rats by cerebral compression and intraveneous norepinephrine. We used scintiphotographic method to demonstrate the blood volume change in the lung subsequent to the hemodynamic events that cause PEH.A specific isotope, Indium-113m, was chosen for this purpose. The isotope forms large molecular complex with plasma transferring (molecular weight of roughly 90,000). It is evenly distributed inside the intravascular space. Normally, the lung showed little radioactivity. After cerebral compression or intravenous norepinephrine, a marked increase in radioactivity of the lung was evident. This indicates an accumulation of blood volume in that area. All the animals developed severe PEH which was proved postmortemly. Findings of the present as well as the previous studies agree with each other and indicate that either cerebral compression or norepinephrine elicits generalized systemic vasoconstriction, causing a shift of large amount of blood into the lung. The hemodynamic changes finally result in pulmonary hypertension and subsequent PEH. The scintiphotographic method may be employed as a diagnostic tool when a hypervolemic lung change is suspected. Further quantitative analysis is to be accomplished for a prospective clinical application.

並列關鍵字

Pulmonary edema and hemorrhage ； Cerebral compression ； Norepinephrine ； Isotope ； Indium-113m ； Scintiphotography