Soubrane O, Braillon A, Lin H C, Kleber G, Lebrec D
Laboratoire d'Hémodynamique Splanchnique, Unité de Recherches de Physiopathologie Hépatique (INSERM U-24), Hôpital Beaujon, Clichy, France.
Hepatology. 1992 Dec;16(6):1447-51. doi: 10.1002/hep.1840160622.
Because superior mesenteric arterial blood flow is increased in portal hypertension and plays a role in elevated portal pressure, mechanical reduction of artery diameter should induce decreases in portal pressure and superior mesenteric arterial blood flow. In this study, calibrated superior mesenteric artery stenosis (induced with a 22-gauge needle) was performed in rats simultaneously with portal vein stenosis or 2 wk after creation of portal vein stenosis. Hemodynamic studies were performed 3 wk after induction of portal vein stenosis in conscious, unrestrained rats. At that time, neither weight loss nor digestive tract alterations were observed in rats with arterial stenosis. In neither group of rats with arterial stenosis was portal tributary blood flow significantly different from that of normal rats; nor was it significantly lower than in rats with portal vein stenosis without arterial stenosis. In both groups of rats with arterial stenosis, portal pressure was significantly lower (12.1 +/- 1.6 mm Hg and 12.5 +/- 1.8 mm Hg, respectively) than in rats subjected to portal vein stenosis (15.4 +/- 1.5 mm Hg) but significantly higher than in controls (7.2 +/- 1.0 mm Hg). In rats with arterial stenosis, cardiac index was also significantly lower than that in rats with portal vein stenosis but higher than that in controls. In conclusion, this study shows that both early and late superior mesenteric artery stenosis significantly reduce the degree of portal hypertension and the hyperkinetic state of rats with extrahepatic portal hypertension. Thus we can speculate that superior mesenteric artery stenosis might provide a new therapeutic approach for portal hypertension.
由于门静脉高压时肠系膜上动脉血流量增加并在门静脉压力升高中起作用，机械性减小动脉直径应可导致门静脉压力和肠系膜上动脉血流量降低。在本研究中，用22号针造成校准的肠系膜上动脉狭窄在大鼠中与门静脉狭窄同时进行，或在门静脉狭窄形成后2周进行。在清醒、不受约束的大鼠中，于门静脉狭窄诱导后3周进行血流动力学研究。此时，动脉狭窄大鼠未观察到体重减轻或消化道改变。两组动脉狭窄大鼠的门静脉分支血流量与正常大鼠相比均无显著差异；也不显著低于无动脉狭窄的门静脉狭窄大鼠。两组动脉狭窄大鼠的门静脉压力均显著低于门静脉狭窄大鼠（分别为12.1±1.6 mmHg和12.5±1.8 mmHg），但显著高于对照组（7.2±1.0 mmHg）。动脉狭窄大鼠的心脏指数也显著低于门静脉狭窄大鼠，但高于对照组。总之，本研究表明，早期和晚期肠系膜上动脉狭窄均能显著降低肝外门静脉高压大鼠的门静脉高压程度和高动力状态。因此我们可以推测，肠系膜上动脉狭窄可能为门静脉高压提供一种新的治疗方法。
