Cahill P A, Foster C, Redmond E M, Gingalewski C, Wu Y, Sitzmann J V
Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Hepatology. 1995 Aug;22(2):598-606.
Portal hypertension (PHT) is characterized by splanchnic hyperemia caused by a reduction in mesenteric vascular resistance. Mediators of this hyperemia include nitric oxide (NO). This is based on several reports indicating a marked splanchnic hyporesponsiveness in PHT to vaso-constrictor stimuli, both in vitro and in vivo, and a subsequent reversal using specific inhibitors of NO synthase (NOS). The objective of this study was to determine directly if the generation of NO is altered in PHT vasculature. Thus, we compared NOS activity in the hyperemic vasculature of normal rabbits and rabbits with PHT (after undergoing partial portal vein ligation). Nicotinamide adenine dinucleotide phosphate diaphorase staining indicated the presence of NOS within the vascular endothelium. Ca(2+)-dependent NOS activity was significantly increased (P < .05) in PHT particulate fractions from the superior mesenteric artery and thoracic aorta, but not from the portal vein. There was no change in NOS activity within the cytosolic fractions. Arterial wall cyclic guanosine monophosphate (cGMP) levels and plasma nitrite levels were both significantly increased in PHT. These results show enhanced NOS activity in PHT hyperemic vessels concurrent with increased tissue cGMP levels. We conclude that enhanced NO synthesis contributes to the hyperdynamic circulation of PHT.
门脉高压(PHT)的特征是由于肠系膜血管阻力降低引起的内脏充血。这种充血的介质包括一氧化氮(NO)。这是基于几份报告,这些报告表明,无论是在体外还是体内,PHT对血管收缩刺激的内脏反应明显降低,随后使用一氧化氮合酶(NOS)的特异性抑制剂可使其逆转。本研究的目的是直接确定PHT血管系统中NO的生成是否改变。因此,我们比较了正常兔和PHT兔(在进行部分门静脉结扎后)充血血管中的NOS活性。烟酰胺腺嘌呤二核苷酸磷酸黄递酶染色表明血管内皮细胞内存在NOS。肠系膜上动脉和胸主动脉的PHT颗粒部分中,钙依赖性NOS活性显著增加(P < 0.05),但门静脉中没有增加。胞质部分的NOS活性没有变化。PHT患者的动脉壁环鸟苷酸(cGMP)水平和血浆亚硝酸盐水平均显著升高。这些结果表明,PHT充血血管中的NOS活性增强,同时组织cGMP水平升高。我们得出结论,NO合成增强有助于PHT的高动力循环。