Deflandre J, Pirotte J, Etienne M, Carlier J
Département de Clinique et Pathologie Médicales, CHU, Liège, Belgique.
Ann Gastroenterol Hepatol (Paris). 1988 May-Jun;24(3):103-5.
In 10 cirrhotic patients, with two balloon catheters introduced in the right internal jugular vein, the following parameters were measured before and after injection of ketanserine (0.1 mg/kg): cardiac output using the thermo-dilution method, free supra-hepatic pressure, wedged supra-hepatic pressure at rest and during cough, right atrial pressure, pulmonary capillary and arterial pressures. After 30 minutes, the following modifications were recorded: the cardiac output goes from 8.0 +/- 2.4 l/min to 8.7 +/- 2.5 l/min (p less than 0.05); the mean arterial pressure goes from 107.0 +/- 18.8 mmHg to 94.7 +/- 25.9 mmHg (p less than 0.02); the wedged supra-hepatic pressure, during coughing goes from 85.2 +/- 36.1 mmHg to 64.6 +/- 23.1 mmHg (p less than 0.005). As in non-cirrhotic patients, ketanserine causes a drop in the mean arterial pressure and a transient elevation of the cardiac output. Ketanserine is able to lower portal pressure of cirrhotic patients at rest as well as during coughing. These results seem to indicate that the activation of serotonin S2 receptors may play a role in determining the portal hypertension in cirrhotic patients.
在10例肝硬化患者中,通过右颈内静脉插入两根球囊导管,在注射酮色林(0.1毫克/千克)前后测量以下参数:采用热稀释法测量心输出量、游离肝上压力、静息及咳嗽时的肝上楔形压力、右心房压力、肺毛细血管压和动脉压。30分钟后,记录到以下变化:心输出量从8.0±2.4升/分钟增至8.7±2.5升/分钟(p<0.05);平均动脉压从107.0±18.8毫米汞柱降至94.7±25.9毫米汞柱(p<0.02);咳嗽时的肝上楔形压力从85.2±36.1毫米汞柱降至64.6±23.1毫米汞柱(p<0.005)。与非肝硬化患者一样,酮色林导致平均动脉压下降和心输出量短暂升高。酮色林能够降低肝硬化患者静息及咳嗽时的门静脉压力。这些结果似乎表明,5-羟色胺S2受体的激活可能在肝硬化患者门静脉高压的形成中起作用。