Lee S S, Johansen K, Lebrec D
Gastroenterology Research Group, University of Calgary, Alberta, Canada.
Hepatology. 1992 Jan;15(1):117-21. doi: 10.1002/hep.1840150120.
We studied the hemodynamics in four groups of rats with combinations of mesenteric hypertension and portal diversion. Operations created three groups with mesenteric hypertension and different degrees of portal venous diversion: mesenteric vein stenosis, portal vein stenosis and end-to-side portacaval anastomosis with mesenteric vein stenosis, the fourth group had only portacaval anastomosis. A control group had sham operations. Cardiac output, splanchnic blood flows and portosystemic shunt indices were measured with radioactive microspheres. Mesenteric venous pressures in the mesenteric-stenosed, portal-stenosed, portacaval-shunted and end-to-side portacaval anastomosis with mesenteric vein stenosis rats were, respectively, 13.5 +/- 0.6, 15.3 +/- 0.7, 4.3 +/- 0.5 and 13.0 +/- 0.9 mm Hg, which were all significantly different from controls: 8.3 +/- 0.3 mm Hg. Portosystemic shunt indices were also significantly different from each other: controls, 0.4% +/- 0.02%; mesenteric-stenosed, 5.9% +/- 2.3%; and portal-stenosed, 52.1% +/- 4.9%. Cardiac output and splanchnic visceral blood flows were significantly increased in the portal-stenosed rats and the two groups with portacaval anastomoses, with the latter two groups having the highest values. The addition of mesenteric stenosis did not change the blood flows because mesenteric-stenosed rats did not differ from controls and end-to-side portacaval anastomosis with mesenteric vein stenosis rats did not differ from rats with portacaval anastomosis alone. These results suggest that mesenteric venous hypertension per se does not affect hemodynamics but that diversion of portal venous blood from the liver is a critical factor in the development of hyperkinetic circulation in portal hypertension.
我们研究了四组合并肠系膜高血压和门静脉分流的大鼠的血流动力学。手术创建了三组患有肠系膜高血压且门静脉分流程度不同的大鼠：肠系膜静脉狭窄、门静脉狭窄以及肠系膜静脉狭窄伴端侧门腔静脉吻合，第四组仅进行门腔静脉吻合。对照组进行假手术。用放射性微球测量心输出量、内脏血流和门体分流指数。肠系膜静脉狭窄、门静脉狭窄、门腔分流以及肠系膜静脉狭窄伴端侧门腔静脉吻合大鼠的肠系膜静脉压力分别为13.5±0.6、15.3±0.7、4.3±0.5和13.0±0.9 mmHg，均与对照组（8.3±0.3 mmHg）有显著差异。门体分流指数彼此间也有显著差异：对照组为0.4%±0.02%；肠系膜静脉狭窄组为5.9%±2.3%；门静脉狭窄组为52.1%±4.9%。门静脉狭窄大鼠以及两组进行门腔静脉吻合的大鼠的心输出量和内脏血流显著增加，后两组数值最高。增加肠系膜狭窄并未改变血流，因为肠系膜静脉狭窄大鼠与对照组无差异，肠系膜静脉狭窄伴端侧门腔静脉吻合大鼠与仅进行门腔静脉吻合的大鼠无差异。这些结果表明，肠系膜静脉高压本身并不影响血流动力学，但门静脉血从肝脏分流是门静脉高压时高动力循环发展的关键因素。
