肝硬化患者和非肝硬化患者肝脏血流动力学的特征。胰高血糖素输注的影响。

Characterization of hepatic hemodynamics in cirrhotics and non-cirrhotics. Effect of glucagon infusion.

作者信息

Sato N, Kawano S, Matsumura T, Meren H, Yoshihara H, Hijioka T, Eguchi H, Fukui H, Kamada T

机构信息

First Dept. of Medicine, Osaka University Medical School, Japan.

出版信息

Scand J Gastroenterol. 1989 Mar;24(2):223-30. doi: 10.3109/00365528909093040.

DOI:10.3109/00365528909093040

PMID:2928737

Abstract

The effect of glucagon on hepatic regional hemodynamics was investigated in patients with chronic liver disease during peritoneoscopy with reflectance spectrophotometry. When glucagon was infused intravenously in patients with a non-cirrhotic liver, the regional hepatic tissue oxygen consumption, as estimated spectrophotometrically, increased significantly, whereas the index of hepatic tissue blood volume did not change appreciably, and consequently, the oxygen saturation of hemoglobin in the hepatic tissue blood decreased. In contrast, the administration of glucagon in patients with liver cirrhosis resulted in a significant increase in the index of hepatic tissue blood volume and produced a minor increase in hepatic tissue oxygen consumption. The oxygen saturation of hepatic blood hemoglobin tended to increase in the cirrhotics. The result suggests the presence of functional vasoconstriction at the presinusoidal and/or sinusoidal vessels in the cirrhotic liver, possibly due to a decreased vasomotor activity and/or an abnormal regulatory function of vasoactive substances, which are released by glucagon.

摘要

采用反射分光光度法，在慢性肝病患者腹腔镜检查期间，研究了胰高血糖素对肝脏局部血流动力学的影响。在非肝硬化肝脏患者静脉输注胰高血糖素时，通过分光光度法估算的局部肝组织氧耗量显著增加，而肝组织血容量指数无明显变化，因此，肝组织血液中血红蛋白的氧饱和度降低。相比之下，肝硬化患者使用胰高血糖素后，肝组织血容量指数显著增加，肝组织氧耗量略有增加。肝硬化患者肝血血红蛋白的氧饱和度有升高趋势。结果表明，肝硬化肝脏的窦前和/或窦状血管存在功能性血管收缩，这可能是由于血管舒缩活性降低和/或胰高血糖素释放的血管活性物质调节功能异常所致。