Panés J, Casadevall M, Fernández M, Piqué J M, Bosch J, Casamitjana R, Cirera I, Bombí J A, Terés J, Rodés J
Gastroenterology Department, Hospital Clínic, Barcelona, Spain.
Hepatology. 1994 Nov;20(5):1261-70. doi: 10.1002/hep.1840200525.
It has been suggested that estrogen-progestagen therapy may be useful in preventing bleeding from gastric angiodysplasia, a vascular lesion similar to that described in portal-hypertensive gastropathy. In this study we assessed the effects of estrogen-progestagen therapy on gastric microcirculation and systemic and splanchnic hemodynamics in portal-hypertensive and sham-operated rats. One week after the surgical procedure (partial portal vein ligation or sham surgery), animals were given an intramuscular injection of a slow-release preparation of estrogen-progestagen or its vehicle. Two weeks later, gastric mucosal blood flow was measured by means of hydrogen gas clearance, a morphometrical analysis of gastric mucosal blood vessels was performed and systemic and splanchnic hemodynamics were evaluated with a radiolabeled-microspheres technique. In portal-hypertensive rats, estrogen-progestagen therapy induced a significant reduction in gastric mucosal blood flow, number of blood vessels and relative area of vessels. Similar changes, although of lesser magnitude, were achieved with estrogen or progestagen given separately and with the low dose of combined estrogen-progestagen. Estrogen-progestagen treatment also induced significant reductions in portal pressure and porto-collateral resistance without changing systemic or splanchnic hemodynamics. In contrast, estrogen-progestagen treatment did not induce changes in any of the parameters studied in sham-operated rats. We conclude that long-term estrogen-progestagen therapy reduces the gastric hyperemia, increased mucosal vessel density and portal pressure in portal-hypertensive rats.
有人提出，雌激素 - 孕激素疗法可能有助于预防胃血管发育异常出血，胃血管发育异常是一种与门脉高压性胃病中所描述的血管病变相似的病变。在本研究中，我们评估了雌激素 - 孕激素疗法对门脉高压大鼠和假手术大鼠胃微循环以及全身和内脏血流动力学的影响。手术（部分门静脉结扎或假手术）一周后，给动物肌肉注射雌激素 - 孕激素缓释制剂或其溶媒。两周后，通过氢气清除法测量胃黏膜血流量，对胃黏膜血管进行形态计量分析，并使用放射性微球技术评估全身和内脏血流动力学。在门脉高压大鼠中，雌激素 - 孕激素疗法导致胃黏膜血流量、血管数量和血管相对面积显著减少。单独给予雌激素或孕激素以及低剂量的联合雌激素 - 孕激素也能产生类似变化，尽管程度较小。雌激素 - 孕激素治疗还能显著降低门静脉压力和门体侧支循环阻力，而不改变全身或内脏血流动力学。相比之下，雌激素 - 孕激素治疗在假手术大鼠中未引起所研究的任何参数的变化。我们得出结论，长期雌激素 - 孕激素疗法可减轻门脉高压大鼠的胃充血、增加的黏膜血管密度和门静脉压力。
