Oberti F, Sogni P, Cailmail S, Moreau R, Pipy B, Lebrec D
Laboratoire d'Hémodynamique Splanchnique, Unité de Recherches de Physiopathologie Hépatique (INSERM U-24), Hôpital Beaujon, Clichy, France.
Hepatology. 1993 Sep;18(3):621-7.
Although prostaglandins are thought to be involved in the hyperdynamic circulation of portal hypertension, the role of this substance has not been elucidated. Dose-response curves, the hemodynamic effects of prostacyclin (20 micrograms/kg) and its inhibitor indomethacin and measurements of plasma and urinary levels of 6-keto-prostaglandin F1 alpha were compared in three groups of six rats each: normal, with portal vein stenosis and with secondary biliary cirrhosis. Plasma and urinary levels of 6-keto-prostaglandin F1 alpha were higher in rats with portal vein stenosis and cirrhotic rats than in normal rats. Dose-response curves showed similar maximal decreases in arterial pressure in the three groups, whereas the maximal increase in portal pressure was less marked in cirrhotic rats than in normal rats and rats with portal vein stenosis. In normal rats, prostacyclin increased cardiac output by 21% and portal pressure by 41%. Similar increases were observed in rats with portal vein stenosis. In contrast, prostacyclin did not affect cardiac output and portal pressure in cirrhotic rats. Indomethacin induced a more marked vasoconstrictive effect in normal rats than in cirrhotic rats. This study shows that prostacyclin plays a role in the hemodynamic alterations in portal hypertension. Moreover, the hyporeactivity observed in cirrhotic rats suggests that prostacyclin plays a major role in the circulatory changes of portal hypertension due to chronic liver disease.
虽然前列腺素被认为与门静脉高压的高动力循环有关，但该物质的作用尚未阐明。比较了三组每组六只大鼠的剂量反应曲线、前列环素（20微克/千克）及其抑制剂吲哚美辛的血流动力学效应以及血浆和尿液中6-酮-前列腺素F1α水平的测量结果：正常组、门静脉狭窄组和继发性胆汁性肝硬化组。门静脉狭窄大鼠和肝硬化大鼠的血浆和尿液中6-酮-前列腺素F1α水平高于正常大鼠。剂量反应曲线显示三组动脉压的最大降幅相似，而肝硬化大鼠门静脉压的最大增幅低于正常大鼠和门静脉狭窄大鼠。在正常大鼠中，前列环素使心输出量增加21%，门静脉压增加41%。门静脉狭窄大鼠也观察到类似的增加。相比之下，前列环素对肝硬化大鼠的心输出量和门静脉压没有影响。吲哚美辛在正常大鼠中比在肝硬化大鼠中诱导出更明显的血管收缩作用。本研究表明，前列环素在门静脉高压的血流动力学改变中起作用。此外，在肝硬化大鼠中观察到的反应性降低表明，前列环素在慢性肝病所致门静脉高压的循环变化中起主要作用。
