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肝静脉括约肌收缩对中心静脉压向叶间静脉压和门静脉压传导的影响。

Effect of hepatic venous sphincter contraction on transmission of central venous pressure to lobar and portal pressure.

作者信息

Lautt W W, Legare D J, Greenway C V

机构信息

Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Manitoba, Winnipeg, Canada.

出版信息

Can J Physiol Pharmacol. 1987 Nov;65(11):2235-43. doi: 10.1139/y87-354.

Abstract

In dogs anesthetized with pentobarbital, central vena caval pressure (CVP), portal venous pressure (PVP), and intrahepatic lobar venous pressure (proximal to the hepatic venous sphincters) were measured. The objective was to determine some characteristics of the intrahepatic vascular resistance sites (proximal and distal to the hepatic venous sphincters) including testing predictions made using a recent mathematical model of distensible hepatic venous resistance. The stimulus used was a brief rise in CVP produced by transient occlusion of the thoracic vena cava in control state and when vascular resistance was elevated by infusions of norepinephrine or histamine, or by nerve stimulation. The percent transmission of the downstream pressure rise to upstream sites past areas of vascular resistance was elevated. Even small increments in CVP are partially transmitted upstream. The data are incompatible with the vascular waterfall phenomenon which predicts that venous pressure increments are not transmitted upstream until a critical pressure is overcome and then further increments would be 100% transmitted. The hepatic sphincters show the following characteristics. First, small rises in CVP are transmitted less than large elevations; as the CVP rises, the sphincters passively distend and allow a greater percent transmission upstream, thus a large rise in CVP is more fully transmitted than a small rise in CVP. Second, the amount of pressure transmission upstream is determined by the vascular resistance across which the pressure is transmitted. As nerves, norepinephrine, or histamine cause the hepatic sphincters to contract, the percent transmission becomes less and the distensibility of the sphincters is reduced. Similar characteristics are shown for the "presinusoidal" vascular resistance and the hepatic venous sphincter resistance.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在使用戊巴比妥麻醉的犬身上,测量了中心静脉压(CVP)、门静脉压(PVP)和肝叶内静脉压(肝静脉括约肌近端)。目的是确定肝内血管阻力部位(肝静脉括约肌近端和远端)的一些特征,包括测试使用最近的可扩张肝静脉阻力数学模型所做的预测。所使用的刺激是在对照状态下以及当通过输注去甲肾上腺素或组胺或通过神经刺激使血管阻力升高时,通过短暂阻断胸段腔静脉产生的CVP短暂升高。下游压力升高向经过血管阻力区域的上游部位的传递百分比升高。即使CVP的小幅升高也会部分向上游传递。这些数据与血管瀑布现象不相符,血管瀑布现象预测静脉压力升高直到克服临界压力才会向上游传递,然后进一步升高将100%传递。肝括约肌表现出以下特征。首先,CVP的小幅升高比大幅升高传递得少;随着CVP升高,括约肌被动扩张并允许更大百分比向上游传递,因此CVP的大幅升高比小幅升高传递得更充分。其次,向上游传递的压力量由压力传递所经过的血管阻力决定。当神经、去甲肾上腺素或组胺导致肝括约肌收缩时,传递百分比降低,括约肌的可扩张性降低。“窦前”血管阻力和肝静脉括约肌阻力也表现出类似特征。(摘要截短于250字)

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