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肝神经、去甲肾上腺素、血管紧张素及中心静脉压升高对猫肝窦后阻力部位和肝内压力的影响。

Effect of hepatic nerves, norepinephrine, angiotensin, and elevated central venous pressure on postsinusoidal resistance sites and intrahepatic pressures in cats.

作者信息

Lautt W W, Greenway C V, Legare D J

出版信息

Microvasc Res. 1987 Jan;33(1):50-61. doi: 10.1016/0026-2862(87)90006-9.

Abstract

Portal venous pressure was controlled by resistance localized to specific sites in hepatic lobar veins in cats. All of the pressure drop from the portal vein to the vena cava occurred across postsinusoidal vessels; portal pressure, lobar venous pressure, and, therefore, sinusoidal pressure were not significantly different. Norepinephrine and angiotensin infusions (intraportal) caused elevation in portal pressure due to constriction of hepatic venous resistance sites as well as some constriction of presinusoidal (portal or sinusoidal) resistance sites. At low doses of norepinephrine presinusoidal constriction dominated whereas at higher doses the postsinusoidal constriction increased proportionately more. Hepatic nerve stimulation produced a similar response measured at an early time (1 min), but by 3 min the presinusoidal constriction showed complete escape so that elevated portal pressure was entirely due to hepatic venous constriction. The same site that provided basal vascular resistance also provided the increased hepatic venous resistance with nerve stimulation and infusion of angiotensin and norepinephrine. Rapid elevation of central venous pressure (CVP) caused elevated sinusoidal pressure. At high CVP (16 mm Hg), 75% of a rise in CVP was transmitted whereas at normal CVP (less than 4.5 mm Hg) less than 20% transmission occurred. The presence of a high resistance in the hepatic veins protected intrahepatic pressure from the effects of normal fluctuation of CVP.

摘要

猫肝叶静脉中特定部位的阻力控制着门静脉压力。从门静脉到腔静脉的所有压力降都发生在肝窦后血管;门静脉压力、肝叶静脉压力以及肝窦压力并无显著差异。去甲肾上腺素和血管紧张素(经门静脉内)输注会导致门静脉压力升高,这是由于肝静脉阻力部位收缩以及肝窦前(门静脉或肝窦)阻力部位的一些收缩所致。在低剂量去甲肾上腺素作用下,肝窦前收缩占主导,而在高剂量时,肝窦后收缩增加得更多。肝神经刺激在早期(1分钟)测量时产生类似反应,但到3分钟时,肝窦前收缩完全消失,因此门静脉压力升高完全是由于肝静脉收缩所致。提供基础血管阻力的同一部位,在神经刺激以及血管紧张素和去甲肾上腺素输注时,也会导致肝静脉阻力增加。中心静脉压(CVP)的快速升高会导致肝窦压力升高。在高CVP(16mmHg)时,CVP升高的75%会传递过去,而在正常CVP(小于4.5mmHg)时,传递过去的不到20%。肝静脉中的高阻力可保护肝内压力免受CVP正常波动的影响。

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