Kleber G, Braillon A, Gaudin C, Champigneulle B, Cailmail S, Lebrec D
Laboratoire d'Hémodynamique Splanchnique, INSERM U-24, Hôpital Beaujon, Clichy, France.
Gastroenterology. 1992 Jul;103(1):282-8. doi: 10.1016/0016-5085(92)91124-m.
Acute infections may influence the hemodynamic alterations of liver disease. Therefore, the hemodynamic effects of endotoxin (LPS E. coli 0111:B4) in conscious, normal, and cirrhotic rats were compared. Endotoxin decreased cardiac index in cirrhotic but not in normal rats. Although the effect of endotoxin on portal tributary blood flow was minor in all animals, a reduction in portal pressure was found in cirrhotic rats. Because the most marked hemodynamic effects were observed in cirrhotic rats, the second part of our study investigated whether platelet activating factor played a role in endotoxin-induced hemodynamic alterations in the cirrhotic model. Platelet activating factor reduced cardiac index and kidney blood flow but did not influence portal tributary blood flow. Two antagonists to platelet activating factor reduced the adverse renal blood flow lowering effects of endotoxin in cirrhotic rats. Thus, it is suggested that the hemodynamic changes observed in cirrhosis may be aggravated during acute infections. Under this condition, antagonists to platelet activating factor may be of benefit in the prevention of hemodynamic complications induced by endotoxin.
急性感染可能影响肝脏疾病的血流动力学改变。因此,比较了内毒素(大肠杆菌0111:B4脂多糖)对清醒的正常大鼠和肝硬化大鼠的血流动力学影响。内毒素可降低肝硬化大鼠的心脏指数,但对正常大鼠无此作用。虽然内毒素对所有动物门静脉分支血流的影响较小,但在肝硬化大鼠中发现门静脉压力降低。由于在肝硬化大鼠中观察到最显著的血流动力学效应,我们研究的第二部分探讨了血小板活化因子在肝硬化模型中内毒素诱导的血流动力学改变中是否起作用。血小板活化因子降低了心脏指数和肾血流量,但不影响门静脉分支血流。两种血小板活化因子拮抗剂减轻了内毒素对肝硬化大鼠肾血流量的不良降低作用。因此,提示肝硬化时观察到的血流动力学变化在急性感染期间可能会加重。在此情况下,血小板活化因子拮抗剂可能有助于预防内毒素诱导的血流动力学并发症。