Calès P, Braillon A, Girod C, Lebrec D
J Hepatol. 1985;1(4):349-57. doi: 10.1016/s0168-8278(85)80772-8.
Propranolol decreases portal venous pressure in patients with cirrhosis but no method is available in man to study the effect of this beta-blocker on splanchnic organ blood flow. Because in rats, the microsphere method allows evaluation of regional blood flow, the acute effect of propranolol on both splanchnic and systemic circulations was studied in normal rats and in rats with portal hypertension due to portal vein stenosis. Portal venous pressure significantly decreased during propranolol administration in normal (5.6 +/- 1.0-4.7 +/- 1.1 mm Hg; mean +/- SD) as well as in portal hypertensive rats (11.7 +/- 2.3-10.3 +/- 1.8 mm Hg). Propranolol slightly decreased cardiac output and arterial pressure in all rats. Portal tributary blood flow was significantly reduced by propranolol in normal rats (17.4 +/- 3.0-11.3 +/- 2.2 ml/min) and in portal hypertensive rats (23.7 +/- 5.0-16.6 +/- 3.3 ml/min). Accordingly vascular resistance of the different organs in the portal venous territory increased in these rats receiving propranolol. The percentage of the decrease in portal tributary blood flow was significantly more marked than the percentage of reduction in cardiac output in portal hypertensive rats but, in normal rats, these percentages were parallel. Hepatic arterial blood flow did not change or slightly increased and, consequently, hepatic arterial vascular resistance decreased. These findings further clarify the marked effects of propranolol on splanchnic circulation.
普萘洛尔可降低肝硬化患者的门静脉压力,但目前尚无在人体中研究这种β受体阻滞剂对内脏器官血流影响的方法。由于在大鼠中,微球法可用于评估局部血流,因此研究了普萘洛尔对正常大鼠和门静脉狭窄所致门静脉高压大鼠的内脏和全身循环的急性影响。在给予普萘洛尔期间,正常大鼠(5.6±1.0 - 4.7±1.1 mmHg;平均值±标准差)和门静脉高压大鼠(11.7±2.3 - 10.3±1.8 mmHg)的门静脉压力均显著降低。普萘洛尔使所有大鼠的心输出量和动脉压略有降低。普萘洛尔使正常大鼠(17.4±3.0 - 11.3±2.2 ml/min)和门静脉高压大鼠(23.7±5.0 - 16.6±3.3 ml/min)的门静脉分支血流显著减少。相应地,接受普萘洛尔的这些大鼠门静脉区域不同器官的血管阻力增加。门静脉高压大鼠门静脉分支血流减少的百分比显著高于心输出量减少的百分比,但在正常大鼠中,这些百分比是平行的。肝动脉血流未改变或略有增加,因此肝动脉血管阻力降低。这些发现进一步阐明了普萘洛尔对内脏循环的显著影响。