Sogni P, Moreau R, Ohsuga M, Cailmail S, Oberti F, Hadengue A, Pussard E, Lebrec D
Laboratoire d'Hémodynamique Splanchnique, Unité de Recherches de Physiopathologie Hépatique (INSERM U-24), Hôpital Beaujon, Clichy, France.
Hepatology. 1992 Oct;16(4):980-3. doi: 10.1002/hep.1840160421.
Because it has been hypothesized that the hyperkinetic circulation in portal hypertension is the result of increased synthesis of nitric oxide, we compared the hemodynamic effects of nitric oxide synthesis--specific agonist (L-arginine) and antagonist between normal and cirrhotic conscious rats. The dose-response curves showed that L-arginine significantly decreased arterial pressure and increased heart rate. These changes started at the 200 mg/kg dose and were similar in both groups of rats. In both groups of rats NG-monomethyl-L-arginine (25 mg/kg) significantly decreased cardiac output by 35%. In cirrhotic rats, NG-monomethyl-L-arginine decreased portal pressure from 15.3 +/- 0.9 mm Hg to 13.6 +/- 0.7 mm Hg and portal tributary blood flow from 7.8 +/- 0.7 ml.min-1.100 gm-1 to 5.9 +/- 0.7 ml.min-1.100 gm-1; it significantly increased portal territory vascular resistance from 950 +/- 108 dyn.sec.cm-5.100 gm-1 x 10(3) to 1,579 +/- 258 dyn.sec.cm-5.100 gm-1 x 10(3). In normal rats, portal tributary blood flow decreased similarly, by 27%, and portal territory vascular resistance increased by 55%. In neither group was hepatic arterial blood flow altered. Before and after NG-monomethyl-L-arginine administration, arterial cyclic GMP concentrations were not significantly different between normal and cirrhotic rats. In conclusion, this study shows evidence of a normal role for nitric oxide-mediated vasodilatation in rats with cirrhosis and that inhibition of nitric oxide synthesis reduces portal hypertension. These results did not support the hypothesis that nitric oxide synthesis is increased in cirrhosis.
由于有假说认为门静脉高压时的高动力循环是一氧化氮合成增加的结果,我们比较了一氧化氮合成特异性激动剂(L-精氨酸)和拮抗剂对正常和肝硬化清醒大鼠的血流动力学影响。剂量反应曲线显示,L-精氨酸显著降低动脉压并增加心率。这些变化在200mg/kg剂量时开始,两组大鼠相似。两组大鼠中,NG-单甲基-L-精氨酸(25mg/kg)显著降低心输出量35%。在肝硬化大鼠中,NG-单甲基-L-精氨酸使门静脉压从15.3±0.9mmHg降至13.6±0.7mmHg,门静脉分支血流量从7.8±0.7ml·min⁻¹·100g⁻¹降至5.9±0.7ml·min⁻¹·100g⁻¹;它使门静脉区域血管阻力从950±108dyn·sec·cm⁻⁵·100g⁻¹×10³显著增加至1579±258dyn·sec·cm⁻⁵·100g⁻¹×10³。在正常大鼠中,门静脉分支血流量同样减少27%,门静脉区域血管阻力增加55%。两组大鼠的肝动脉血流量均未改变。在给予NG-单甲基-L-精氨酸前后,正常和肝硬化大鼠的动脉环磷酸鸟苷浓度无显著差异。总之,本研究表明一氧化氮介导的血管舒张在肝硬化大鼠中发挥正常作用,且抑制一氧化氮合成可降低门静脉高压。这些结果不支持肝硬化时一氧化氮合成增加的假说。