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犬肝静脉阻力部位:肝内压力测量的定位与验证

Hepatic venous resistance site in the dog: localization and validation of intrahepatic pressure measurements.

作者信息

Legare D J, Lautt W W

出版信息

Can J Physiol Pharmacol. 1987 Mar;65(3):352-9. doi: 10.1139/y87-061.

Abstract

Intrahepatic pressure (9.4 +/- 0.3 mmHg; 1 mmHg = 133.32 Pa), measured proximal to a hepatic venous resistance site, was insignificantly different from portal venous pressure (9.6 +/- 0.4 mmHg). This lobar venous pressure is not wedged hepatic venous pressure as it is measured from side holes in a catheter with a sealed tip. Validation of the lobar venous pressure measurement was done in a variety of ways and using different sizes and configurations of catheters. The site of hepatic venous resistance in the dog is localized to a narrow sphincterlike region about 0.5 cm in length and within 1-2 cm (usually within 1 cm) of the junction of the vena cava and hepatic veins. Sinusoidal and portal venous resistance appears insignificant in the basal state and large increases in liver blood volume (histamine infusion or passive vena caval occlusion) or large decreases in liver blood volume (passive vascular occlusion) do not alter the insignificant pressure gradient between portal and lobar venous pressures. Norepinephrine infusion (1.25 microgram X kg-1 X min-1 intraportal) and hepatic sympathetic nerve stimulation (10 Hz) led to a significantly greater rise in portal venous pressure than in lobar venous pressure, indicating some presinusoidal (and (or) sinusoidal) constriction and this indicates that lobar venous pressure cannot be assumed under all conditions to accurately reflect portal pressure. However, most of the rise in portal venous pressure induced by intraportal infusion of norepinephrine or nerve stimulation and virtually all of the pressure rise induced by histamine could be attributed to the postsinusoidal resistance site.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在肝静脉阻力部位近端测得的肝内压力(9.4±0.3 mmHg;1 mmHg = 133.32 Pa)与门静脉压力(9.6±0.4 mmHg)无显著差异。这种叶静脉压力并非楔入式肝静脉压力,因为它是通过带有密封尖端的导管侧孔测量的。叶静脉压力测量的验证通过多种方式进行,并使用了不同尺寸和配置的导管。犬肝静脉阻力部位定位于一个狭窄的括约肌样区域,长度约0.5 cm,位于腔静脉与肝静脉交界处1 - 2 cm内(通常在1 cm内)。在基础状态下,窦状隙和门静脉阻力似乎不显著,肝血容量大幅增加(输注组胺或被动腔静脉阻塞)或肝血容量大幅减少(被动血管阻塞)不会改变门静脉和叶静脉压力之间不显著的压力梯度。门静脉内输注去甲肾上腺素(1.25微克·千克⁻¹·分钟⁻¹)和刺激肝交感神经(10 Hz)导致门静脉压力升高显著大于叶静脉压力升高,表明存在一些窦前(和/或窦状隙)收缩,这表明在所有情况下都不能认为叶静脉压力能准确反映门静脉压力。然而,门静脉内输注去甲肾上腺素或神经刺激引起的门静脉压力升高大部分以及组胺引起的几乎所有压力升高都可归因于窦后阻力部位。(摘要截短于250字)

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