Johansen K, Girod C, Lee S S, Lebrec D
Unité de Recherches de Physiopathologie Hépatique (INSERM U-24), Hôpital Beaujon, Clichy, France.
Eur Surg Res. 1990;22(3):170-4. doi: 10.1159/000129098.
Hyperammonemia is a constant finding following portacaval anastomosis (PCA), and has been incriminated in the neurologic deterioration observed following portasystemic shunt in humans. We developed a rat model for mesenteric venous hypertension by modification of a commonly used technique for studying extrahepatic portal hypertension. We then examined serum ammonia levels in rats undergoing sham operation, mesenteric vein stenosis (MVS) alone, PCA alone, and MVS plus PCA. All MVS animals had a significant (p less than 0.05) elevation in mesenteric venous pressures 2-3 weeks after operation. Serum ammonia levels were normal in rats undergoing sham operation and MVS, and were significantly elevated (p less than 0.001) in rats with PCA. However, a significant (p less than 0.01) reduction in serum ammonia levels was realized when PCA and MVS were combined. These data suggest that intestinal ammonia absorption is a function of splanchnic venous pressure. These findings may be relevant to the management of the neuropsychiatric deterioration seen following PCA in man.
高氨血症是门腔静脉吻合术（PCA）后持续存在的表现，并且被认为与人类门体分流术后出现的神经功能恶化有关。我们通过改良一种常用的研究肝外门静脉高压的技术，建立了肠系膜静脉高压大鼠模型。然后，我们检测了接受假手术、单纯肠系膜静脉狭窄（MVS）、单纯PCA以及MVS加PCA的大鼠的血清氨水平。所有MVS动物在术后2至3周肠系膜静脉压力均显著升高（p<0.05）。接受假手术和MVS的大鼠血清氨水平正常，而PCA大鼠的血清氨水平显著升高（p<0.001）。然而，当PCA和MVS联合时，血清氨水平显著降低（p<0.01）。这些数据表明，肠道氨吸收是内脏静脉压力的一个函数。这些发现可能与人类PCA后出现的神经精神恶化的管理有关。
