Pomier-Layrargues G, Huet P M, Richer G, Marleau D, Viallet A
Dig Dis Sci. 1980 Jul;25(7):489-93. doi: 10.1007/BF01315210.
The relative importance of portal hypertension and intrahepatic portal-systemic shunting in the pathogenesis of hyperglobulinemia is examined in 31 alcoholic cirrhotic patients and 6 patients with idiopathic portal hypertension. The degree of portal hypertension was evaluated by combined umbilicoportal and hepatic vein catheterization and the intrahepatic portal-systemic hunting was assessed by the Kupffer uptake of [125I]albumin microaggregates during a single passage through the liver. All patients had comparable severe portal hypertension and most had bled from ruptured varices; however, no demonstrable relationship could be found between portal hypertension and hyperglobulinemia. Elevated levels of serum gammaglobulins and immunoglobulins (mainly IgG) were observed only in cirrhotic patients, particularly those with markedly altered Kupffer cell uptake. It is concluded that intrahepatic portal systemic shunting as evaluated by the Kupffer cell uptake is more important than the collateral circulation secondary to portal hypertension in the pathogenesis of hyperglobulinemia in alcoholic cirrhotic patients.
在31例酒精性肝硬化患者和6例特发性门静脉高压患者中，研究了门静脉高压和肝内门体分流在高球蛋白血症发病机制中的相对重要性。通过联合脐门静脉和肝静脉插管评估门静脉高压程度，通过[125I]白蛋白微聚体单次通过肝脏期间库普弗细胞摄取情况评估肝内门体分流。所有患者均有相当严重的门静脉高压，且大多数患者曾因曲张静脉破裂出血；然而，未发现门静脉高压与高球蛋白血症之间存在明显关联。仅在肝硬化患者中观察到血清γ球蛋白和免疫球蛋白（主要是IgG）水平升高，尤其是那些库普弗细胞摄取明显改变的患者。得出结论，在酒精性肝硬化患者高球蛋白血症的发病机制中，通过库普弗细胞摄取评估的肝内门体分流比门静脉高压继发的侧支循环更为重要。
