Claria J, Jiménez W, Arroyo V, La Villa G, López C, Asbert M, Castro A, Gaya J, Rivera F, Rodés J
Hormonal Laboratory, Hospital Clínic i Provincial, Barcelona, Spain.
Gastroenterology. 1991 Feb;100(2):494-501. doi: 10.1016/0016-5085(91)90222-7.
Angiotensin II blockade with saralasin in human cirrhosis with ascites is associated with a significant reduction in arterial pressure, indicating that endogenous angiotensin II plays an important role in the maintenance of systemic hemodynamics in this condition. The aim of the current study was to investigate whether vasopressin also contributes to the maintenance of arterial pressure in cirrhosis with ascites. The study was performed using three groups of cirrhotic rats with ascites and three groups of control animals. The administration of d(CH2)5Tyr(Me)AVP, a selective antagonist of the vascular effect of vasopressin, to 10 cirrhotic rats induced a significant reduction in mean arterial pressure (from 94 +/- 4 to 85 +/- 4 mm Hg; P less than 0.001) and a significant increase in plasma renin activity (from 24.3 +/- 4.9 to 34.3 +/- 5.9 ng/mL.h; P less than 0.02) and plasma norepinephrine concentration (from 1474 +/- 133 to 2433 +/- 253 pg/mL; P less than 0.01). Similar results were observed following saralasin administration in a second group of 5 cirrhotic rats [mean arterial pressure decreased from 97 +/- 4 to 85 +/- 5 mm Hg (P less than 0.0001); and plasma renin activity and norepinephrine concentration increased from 18.4 +/- 5.8 to 40.3 +/- 5.7 ng/mL.h (P less than 0.02) and from 1383 +/- 70 to 2312 +/- 334 pg/mL (P less than 0.05), respectively]. The simultaneous blockade of angiotensin II and vasopressin in a third group of cirrhotic rats resulted in a significantly greater reduction of mean arterial pressure (from 97 +/- 6 to 74 +/- 6 mm Hg; P less than 0.05). No changes in arterial pressure were observed in the three groups of control rats. These findings indicate that endogenous vasopressin is as important as angiotensin II in the maintenance of arterial pressure in cirrhotic rats with ascites and support the contention that arterial hypotension is the initial event leading to the stimulation of the renin-angiotensin system and vasopressin in this animal model of cirrhosis.
用沙拉新阻断人类肝硬化腹水患者体内的血管紧张素II,会导致动脉压显著降低,这表明内源性血管紧张素II在维持这种情况下的全身血流动力学中起重要作用。本研究的目的是调查血管加压素是否也有助于维持肝硬化腹水患者的动脉压。该研究使用了三组肝硬化腹水大鼠和三组对照动物进行。给10只肝硬化大鼠注射血管加压素血管效应的选择性拮抗剂d(CH2)5Tyr(Me)AVP,导致平均动脉压显著降低(从94±4降至85±4 mmHg;P<0.001),血浆肾素活性显著升高(从24.3±4.9升至34.3±5.9 ng/mL·h;P<0.02),血浆去甲肾上腺素浓度显著升高(从1474±133升至2433±253 pg/mL;P<0.01)。在第二组5只肝硬化大鼠中注射沙拉新后也观察到了类似结果[平均动脉压从97±4降至85±5 mmHg(P<0.0001);血浆肾素活性和去甲肾上腺素浓度分别从18.4±5.8升至40.3±5.7 ng/mL·h(P<0.02)和从1383±70升至2312±334 pg/mL(P<0.05)]。在第三组肝硬化大鼠中同时阻断血管紧张素II和血管加压素,导致平均动脉压显著更大幅度降低(从97±6降至74±6 mmHg;P<0.05)。三组对照大鼠的动脉压未观察到变化。这些发现表明,内源性血管加压素在维持肝硬化腹水大鼠的动脉压方面与血管紧张素II同样重要,并支持动脉低血压是导致该肝硬化动物模型中肾素-血管紧张素系统和血管加压素受刺激的初始事件这一论点。