Niederberger M, Ginès P, Tsai P, Martin P Y, Morris K, Weigert A, McMurtry I, Schrier R W
Department of Medicine, University Hospital of Bern, Switzerland.
Hepatology. 1995 Jun;21(6):1625-31.
Arterial vasodilation is considered to be the key factor in the development of sodium and water retention leading to ascites formation in cirrhosis. To determine if nitric oxide (NO) is involved in the pathogenesis of arterial vasodilation in cirrhosis, we measured the concentration of cyclic guanosine monophosphate (cGMP), the second messenger of NO, in arterial tissue from rats with carbon tetrachloride-induced cirrhosis. Aortic cGMP concentration was markedly increased in cirrhotic rats, particularly in those with ascites (ascites, 826 +/- 70; no ascites, 597 +/- 48; controls, 331 +/- 25 fmol/mg, ANOVA F = 23.1, P < .0001), and correlated inversely with arterial pressure (r = -.56, P < .0001) and systemic vascular resistance (r = -.69, P = .014) and directly with cardiac index (r = .74, P < .01). The chronic administration of the NO synthesis inhibitor NG-nitro-L-arginine-methyl-ester (L-NAME) (10 mg/kg/day for 7 days) induced a marked reduction in aortic cGMP concentration in cirrhotic rats with ascites to similar values obtained in L-NAME-treated control rats (86 +/- 14 vs. 89 +/- 8 fmol/mg, respectively, NS), indicating that the high-aortic cGMP content in cirrhotic rats was caused by an increased NO synthesis. Mean arterial pressure after L-NAME treatment increased to similar values in both groups of animals. These results suggest that in cirrhosis there is an increased vascular production of NO that may play a role in the pathogenesis of arterial vasodilation.
动脉血管舒张被认为是肝硬化患者钠水潴留导致腹水形成过程中的关键因素。为了确定一氧化氮(NO)是否参与肝硬化患者动脉血管舒张的发病机制,我们测定了四氯化碳诱导的肝硬化大鼠动脉组织中NO的第二信使环磷酸鸟苷(cGMP)的浓度。肝硬化大鼠主动脉cGMP浓度显著升高,尤其是有腹水的大鼠(腹水组,826±70;无腹水组,597±48;对照组,331±25 fmol/mg,方差分析F=23.1,P<.0001),且与动脉压呈负相关(r=-.56,P<.0001),与全身血管阻力呈负相关(r=-.69,P=.014),与心脏指数呈正相关(r=.74,P<.01)。长期给予NO合成抑制剂NG-硝基-L-精氨酸甲酯(L-NAME)(10 mg/kg/天,共7天)可使有腹水的肝硬化大鼠主动脉cGMP浓度显著降低,降至与L-NAME处理的对照大鼠相似的水平(分别为86±14和89±8 fmol/mg,无显著性差异),表明肝硬化大鼠主动脉cGMP含量升高是由NO合成增加所致。两组动物L-NAME治疗后的平均动脉压均升高至相似水平。这些结果表明,在肝硬化患者中,血管NO生成增加,可能在动脉血管舒张的发病机制中起作用。