摘要
目的探讨门静脉压力升高和门静脉体循环分流与前列环素(PGI_2)水平升高的关系。方法 36只雄性 SD 大鼠随机分为四组:肝前型门静脉高压(PHPH)8只和肝内型门静脉高压(IHPH)9只,端侧门静脉下腔静脉分流(PCS)8只及正常对照组(假手术)(SO)11只。模型制备后2周:(1)测游离门静脉压(FPP);(2)应用核素微球技术研究全身及内脏血流动力学;(3)用放射免疫法测股动脉血浆6-酮-前列腺素 F_(1α)(6-keto-PGF_(1α))浓度。结果 (1)IHPH 和 PHPH 组的 FPP 高于 SO 鼠(P<0.05),而 PCS 鼠低于 SO鼠(P<0.05)。PCS 和 PHPH 鼠心指数(CI)大于 SO 鼠(P<0.05)。IHPH、PHPH 及 PCS 鼠中 PVI 均高于 SO 鼠(P<0.05),且以 PCS 鼠为著。(2)血浆6-keto-PGF_(1α)浓度前三组大于 SO 组(P<0.05),且 PH-PH 和 IHPH 鼠均大于 PCS 鼠(P<0.05)。血浆6-keto-PGF_(1α)浓度与 FPP 值之间呈正相关(r=0.67,P<0.01)。结论门静脉高压时 PGI_2升高主要是门静脉压力升高的结果,而门静脉体循环分流和肝功能减退起次要作用。本研究结果不支持 PGI_2参与门静脉高压高血流动力状态的发生。
Objective To evaluate the role of increased portal pressure and portosystemic shunting in elevated level of prostacyclin(PGI_2) in portal hypertension.Methods Thirty-six male Sprague-Dawley rats were divided into four groups:prehepatic portal hypertension (PHPH,n=8),intrahepatic portal hypertension (IHPH,n=9), end-to-side portacaval shunt (PCS,n=8) and sham-operated controls (SO,n=11).Two weeks after surgery, free portal pressure (FPP) was measured,systemic and splanchnic hemodynamics were studied by radioactive microsphere technique and blood sample from the femoral artery was obtained to measure the level of plasma 6- keto-PGF_(1α)with radio-immunoassay.Results The FPP(mmHg) in IHPH PHPH,PCS and SO rats was 13.1± 1.0,12.1±1.5,6.9±0.7 and 3.0±0.8,respectively.FPP significantly increased in IHPH,PHPH rats and significantly decreased in PCS rats when compared to SO rats.Cardiac index (CI) and portal venous inflow (PVI)were in the order of PCS>PHPH>IHPH>SO rats.Portosystemic shunting rates (PSS) in PCS,PHPH, IHPH were 99.70%±0.29%,76%±21% and 30%±10%,respectively.The concentrations of plasma 6- keto-PGF_(1α)(ng/ml) in PHPH,IHPH,PCS and SO rats were 6.93±2.43,5.09±2.27,2.36±1.01,and 1.56 ±0.61,respectively.The concentrations of plasma PGI_2 in PHPH,IHPH and PCS rats were significantly higher than that in SO rats.Besides,the concentrations in PHPH and IHPH rats were also significantly higher than that in PCS rats.Moreover,a close positive correlation existed between plasma PGI_2 and FPP(r=0.67,P< 0.001).Conclusion The elevated PGI_2 in portal hypertension is mainly due to the overproduction of PGI_2 in vascular epithelium cells induced by increased portal pressure,and portosystemic shunt and liver dysfunction play a secondary role.In addition,the results of the present study do not support that PGI_2 mediated the hyper- hemodynamics in portal hypertension.
出处
《中华普通外科杂志》
CSCD
1998年第2期102-104,共3页
Chinese Journal of General Surgery
关键词
门静脉高压
门静脉压力
前列环素
门体分流术
Hypertension,portal
Portal pressure
Prostaglanding
Shunt,portosystemic
