Braillon A, Koshy A, Lee S S, Girod C, Lebrec D
Unité de Recherches de Physiopathologie Hépatique, INSERM U24, Hôpital Beaujon, Clichy.
Gastroenterol Clin Biol. 1988 Aug-Sep;12(8-9):641-5.
We studied the role of portosystemic shunt development in the maintenance of portal hypertension in a prehepatic portal hypertension rat model. A first group was studied two days after partial portal vein ligation. When portosystemic shunts were negligible; the second group was studied 3 weeks after the partial portal vein ligation, when large portosystemic shunts were present. Portal pressure was significantly higher in the first group than in the second group (19.9 +/- 0.8 mmHg (mean +/- 1 SD) and 12.8 +/- 2.3 mmHg, respectively; p less than 0.001). When compared with sham operated rats: a) portal tributary blood flow (measured with the radioactive microspheres method) was decreased in the first group (- 34 p. 100; p less than 0.01) and increased in the second group (+ 32 p. 100; p less than 0.02); b) portal system vascular resistance was markedly increased in the first group (+ 269 p. 100; p less than 0.001) and did not significantly change in the second group (+ 30 p. 100). These results suggest that portosystemic shunt development decreases portal pressure but not to normal value because portal tributary blood flow is increased. Moreover the increase in portal system vascular resistance and in portal tributary blood flow play different roles in the maintenance of portal hypertension depending on the stage of evolution of portal hypertension.
我们在肝前性门静脉高压大鼠模型中研究了门体分流发展在维持门静脉高压中的作用。第一组在部分门静脉结扎后两天进行研究，此时门体分流可忽略不计；第二组在部分门静脉结扎后3周进行研究，此时存在大量门体分流。第一组的门静脉压力显著高于第二组（分别为19.9±0.8 mmHg（平均值±1标准差）和12.8±2.3 mmHg；p<0.001）。与假手术大鼠相比：a）第一组门静脉分支血流（用放射性微球法测量）减少（-34%；p<0.01），第二组增加（+32%；p<0.02）；b）第一组门静脉系统血管阻力显著增加（+269%；p<0.001），第二组无显著变化（+30%）。这些结果表明，门体分流的发展可降低门静脉压力，但不能降至正常水平，因为门静脉分支血流增加。此外，门静脉系统血管阻力和门静脉分支血流的增加在维持门静脉高压中发挥不同作用，这取决于门静脉高压的演变阶段。
