Canty T G, Jauregizar E, Fernandez-Cruz L
J Pediatr Surg. 1980 Dec;15(6):819-26. doi: 10.1016/s0022-3468(80)80287-9.
Previous attempts to produce sustained portal hypertension in experimental animals by portal venous obstruction have not been successful. Experiments were designed to study the effects of gradual portal venous occlusion plus hepatic lymphatic ligation in the rat. Adult male Lewis rats were divided into three groups: (A) nonoperated or sham-operated; (B) operated, with hepatic lymphatic ligation only; and (C) operated, with placement of a portal vein ameroid constrictor and hepatic lymphatic ligation. There were no differences noted in portal venous pressures (control 9.6 +/- 0.4 cm H2O) and portovenograms between groups A and B throughout the study. In group C there was greater than doubling of portal venous pressure by 1 wk which remained for 2 mo. Portal pressure then fell but remained elevated at greater than 30% above control values for 1 yr. Three systems of collateral circulation developed rapidly in response to this extrahepatic portal venous occlusion: (A) veins directly bridging across the occluding ameroid reestablishing hepatopetal flow which steadily increased; (B) spontaneous portosystemic shunts at the splenorenal area that occur early and then regress; and (C) retroperitoneal, paraesophageal and submucosal esophageal veins that develop late and remain stable. Quantitative assessment of the lumen size of the submucosal esophageal veins revealed a twofold increase in these veins in group B when compared to controls by 4 wk and a fivefold increase in these veins in group C by 8 wk that persisted for 1 yr. This model appears useful for studying the course and effects of extrahepatic portal hypertension and its gradual alteration by the spontaneous development of portosystemic collaterals in the rat. This model may have enough similarities to the extrahepatic portal hypertension seen in children that its use for future studies may be fruitful.
以往通过门静脉阻塞在实验动物中产生持续性门静脉高压的尝试均未成功。本实验旨在研究大鼠门静脉逐渐闭塞加肝淋巴管结扎的效果。成年雄性Lewis大鼠分为三组:(A)未手术或假手术组;(B)仅行肝淋巴管结扎手术组;(C)放置门静脉阿梅氏缩窄环并进行肝淋巴管结扎手术组。在整个研究过程中,A组和B组之间的门静脉压力(对照组9.6±0.4 cm H2O)和门静脉造影未见差异。C组门静脉压力在1周时增加了一倍多,并持续2个月。此后门静脉压力下降,但在1年时间里仍高于对照组值30%以上。为应对这种肝外门静脉闭塞,迅速形成了三种侧支循环系统:(A)直接跨过闭塞的阿梅氏缩窄环的静脉重新建立了向肝血流,且血流稳步增加;(B)脾肾区的自发性门体分流,早期出现,随后消退;(C)腹膜后、食管旁和食管黏膜下静脉,形成较晚且保持稳定。对食管黏膜下静脉管腔大小的定量评估显示,与对照组相比,B组在4周时这些静脉增加了两倍,C组在8周时增加了五倍,并持续1年。该模型似乎有助于研究大鼠肝外门静脉高压的病程和影响,以及门体侧支循环的自发形成对其的逐渐改变。该模型与儿童所见的肝外门静脉高压可能有足够的相似性,未来用于研究可能会有成效。