Merkel C, Gatta A, Bolognesi M, Finucci G, Battaglia G, Angeli P, Zuin R
Department of Clinical Medicine, University of Padua, Italy.
Dig Dis Sci. 1988 Sep;33(9):1103-9. doi: 10.1007/BF01535785.
Triglycyl-lysin-vasopressin is a long-acting vasopressin derivative which is under consideration for the treatment of acute variceal bleeding in cirrhosis. However, its splanchnic hemodynamic effects have not been investigated thoroughly. In 11 patients with alcoholic cirrhosis, systemic and splanchnic hemodynamics were evaluated before and 20-40 min after intravenous administration of 2 mg triglycyl-lysin-vasopressin. Following the drug administration, heart rate decreased by 10% and cardiac index by 22% on the average, respectively; mean arterial pressure increased by 14% and systemic vascular resistence index by 48%. Hepatic venous pressure gradient showed a marked and persistent fall, averaging 31%. Hepatic and splenic blood flow decreased by 31% and 56%, respectively. A significant correlation was found between the decrease in hepatic venous pressure gradient and in splenic blood flow. By contrast, the decrease in the hepatic venous pressure gradient was not significantly correlated to the decrease in hepatic blood flow or in cardiac index. We conclude that in patients with alcoholic cirrhosis, triglycyl-lysin-vasopressin decreases portal pressure as well as hepatic and splenic blood flows. The decrease in portal pressure was due to the decrease in splanchnic blood inflow and not to the decrease in cardiac index.
三甘氨酰赖氨酸加压素是一种长效加压素衍生物，正考虑用于治疗肝硬化急性静脉曲张出血。然而，其内脏血流动力学效应尚未得到充分研究。在11例酒精性肝硬化患者中，静脉注射2毫克三甘氨酰赖氨酸加压素前及注射后20 - 40分钟评估全身和内脏血流动力学。给药后，平均心率分别下降10%，心脏指数下降22%；平均动脉压升高14%，全身血管阻力指数升高48%。肝静脉压力梯度显著且持续下降，平均下降31%。肝血流量和脾血流量分别下降31%和56%。肝静脉压力梯度下降与脾血流量下降之间存在显著相关性。相比之下，肝静脉压力梯度下降与肝血流量或心脏指数下降无显著相关性。我们得出结论，在酒精性肝硬化患者中，三甘氨酰赖氨酸加压素可降低门静脉压力以及肝血流量和脾血流量。门静脉压力下降是由于内脏血流流入减少，而非心脏指数下降。
