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吐酒石中毒死亡病人大多死于心臟因素,动物实驗也表現有抑制心脏作用,本文从心臟血流动力作用的变化来說明吐酒石中毒时的循环障碍。狗26只,三氯醛糖麻醉,根据Fick氏原理测定心輸出量。在X光透視下插心脏导管取肺动脉及主动脉血,用Roughton-Scholander氏法测定血氧含量。基底代谢测驗器測定氧消耗量,电測压计測定右心房及肺动脉平均压。給藥前各項正常数值(平均±标准差)为:心輸出量1.9±0.6升分,心臟指数3.O±0.9升/分/米~2,心搏量11±3毫升,主动脉平均压168±21毫米汞柱,肺动脉平均压20±6毫米汞柱,总外周阻力8000±2800达因·秒·厘米~(-5),左心室作功量7.1±2.4千克·米/分/米~2,右心室作功量0.65±0.31千克·米/分/米~2。对照組狗在5小时内心輸出量及心搏量基本稳定,主动脉、肺动脉平均压及血管阻力均无大变化,心电圖正常,心室作功量无抑制現象。吐酒石的一次給藥量(2毫克/千克)未引起心臟血流动力作用的显著变化。吐酒石的中毒剂量在15毫克/千克时引起血压显著下降,心輸出量在2小时后似有减少傾向,心电圖T波变平或倒置,总外周阻力变化則不大。剂量在20毫克/千克以上,心臟抑制更为明显,左心室作功量逐漸减弱,右心室作功量初加强以代偿增高之肺血管阻力,当中毒程度加深后亦趋衰竭。中毒时总外周阻力增大,小动脉大多收縮,指示吐酒石之降压作用主要由于抑制心臟,狗在給藥后4—5小时死亡。
Most of the deaths from tartar poisoning die from cardiac factors, and animal experiments also show the effect of inhibiting heart function. This article describes the circulatory disturbance of vomiting tartar poisoning from the change of cardiac hemodynamic effect. Twenty-six dogs, anesthetized with trichlorohydral, measured cardiac output according to Fick’s principle. Cardiac catheter was inserted into pulmonary artery and aorta under X-ray fluoroscopy, and blood oxygen content was measured by Roughton-Scholander’s method. The basal metabolic tester measures oxygen consumption, and the electrical manometer measures the average pressure in the right atrium and pulmonary artery. The normal values (mean ± standard deviation) before administration were: 1.9 ± 0.6 points for cardiac output, 3. 0 ± 0.9 liters / minute / meter for cardiac index, 11 ± 3 ml for cardiac volume, Pressure of 168 ± 21 mmHg and mean pulmonary artery pressure of 20 ± 6 mmHg and total peripheral resistance of 8000 ± 2800 dyne · s · cm-5. The left ventricular work capacity was 7.1 ± 2.4 kg · m / min / M ~ 2, right ventricular work capacity 0.65 ± 0.31 kg m / min / m ~ 2. In the control group, the volume of cardiac output and stroke volume were basically stable within 5 hours. There was no significant change in aortic and pulmonary arterial pressure and vascular resistance. The electrocardiogram was normal and there was no inhibitory effect on ventricular weight. One dose of tartar (2 mg / kg) did not cause significant changes in cardiac hemodynamic effects. The spit tartar poisoning dose at 15 mg / kg caused a significant drop in blood pressure, cardiac output after 2 hours seems to be reduced, ECG T wave flattening or inversion, the total change in peripheral resistance is not large. Dose of 20 mg / kg or more, more obvious inhibition of the heart, left ventricular work was gradually weakened, right ventricular work initially strengthened to compensatory increase in pulmonary vascular resistance, when the deepening of poisoning also tend to failure. Total peripheral resistance increased poisoning, mostly arterioles contractions, indicating that the role of vomiting tartar antihypertensive effect is mainly due to the heart, the dog died 4-5 hours after administration.