López C, Jiménez W, Arroyo V, Clària J, La Villa G, Asbert M, Gaya J, Rivera F, Rodés J
Hormonal Laboratory, Hospital Clínic i Provincial, Barcelona, Spain.
Hepatology. 1991 Mar;13(3):585-9.
It has been proposed that the initial event of sodium retention in cirrhosis is a peripheral arteriolar vasodilation causing underfilling of the arterial vascular compartment and stimulation of the renin-aldosterone and sympathetic nervous systems. To test this hypothesis, systolic blood pressure, sodium balance and urinary excretion of sodium and aldosterone were sequentially measured in 13 conscious spontaneously hypertensive rats submitted to a cirrhosis induction program with carbon tetrachloride and phenobarbital and in 14 control hypertensive animals. No significant differences were found between control and cirrhotic rats in any of the measured parameters during the first 7 wk of the study. The eighth week sodium retention developed in cirrhotic rats as indicated by a positive sodium balance and a marked decrease of sodium excretion. At the same time a significant reduction in systolic blood pressure and a great increase in urinary excretion of aldosterone were detected. These changes were more marked the ninth week of the study. In cirrhotic rats there was a highly significant direct correlation between systolic blood pressure and urinary sodium excretion. Postmortem examination showed a histological picture of cirrhosis in all animals given carbon tetrachloride and ascites in six of them. These results indicate that the onset of hyperaldosteronism and sodium retention in conscious spontaneously hypertensive rats with carbon tetrachloride-induced cirrhosis is chronologically related to a significant decrease in arterial pressure, thus supporting the "peripheral arterial vasodilation hypothesis" of ascites.
有人提出,肝硬化时钠潴留的初始事件是外周小动脉血管舒张,导致动脉血管腔充盈不足,并刺激肾素 - 醛固酮和交感神经系统。为了验证这一假设,对13只经四氯化碳和苯巴比妥诱导肝硬化的清醒自发性高血压大鼠以及14只对照高血压动物,依次测量其收缩压、钠平衡以及钠和醛固酮的尿排泄量。在研究的前7周,对照大鼠和肝硬化大鼠在任何测量参数上均未发现显著差异。在第8周,肝硬化大鼠出现钠潴留,表现为钠平衡为正且钠排泄量显著减少。与此同时,检测到收缩压显著降低,醛固酮尿排泄量大幅增加。这些变化在研究的第9周更为明显。在肝硬化大鼠中,收缩压与尿钠排泄之间存在高度显著的直接相关性。尸检显示,所有给予四氯化碳的动物均有肝硬化组织学表现,其中6只出现腹水。这些结果表明,在四氯化碳诱导肝硬化的清醒自发性高血压大鼠中,醛固酮增多症和钠潴留的发生在时间上与动脉压显著降低相关,从而支持了腹水的“外周动脉血管舒张假说”。