Pilette C, Kirstetter P, Sogni P, Cailmail S, Moreau R, Lebrec D
Laboratoire d'Hémodynamique Splanchnique, Unité de Recherches de Physiopathologie Hépatique (INSERM U-24), Hôpital Beaujon, Clichy, France.
J Gastroenterol Hepatol. 1996 Jan;11(1):1-6. doi: 10.1111/j.1440-1746.1996.tb00002.x.
The role of nitric oxide (NO) in the hyperkinetic circulation in portal hypertension has not been clearly elucidated. Different doses of NO inhibitors, haemodynamic values and experimental conditions might explain the discrepant results. The aim of the present study was to investigate the acute effects of a specific biosynthesis inhibitor of NO, Nomega-nitro-L-arginine (L-NNA), on the systemic and splanchnic circulation in normal conscious rats and rats with portal hypertension due to either partial portal vein stenosis or secondary biliary cirrhosis. The administration of L-NNA (15 to 960 micrograms.kg-1.min-1) induced a significant dose dependent increase in arterial pressure which was not different among the three groups of rats. Following an acute and maximal vasopressive dose of L-NNA (1 mg.kg-1.min-1) cardiac index decreased more in portal vein stenosed and cirrhotic rats (-45 +/- 3% and -45 +/- 2%, respectively) than in normal rats (-31 +/- 2%), and systemic vascular resistance increased more in the two groups of portal hypertensive rats than in normals (+ 161 +/- 13% and + 154 +/- 10% vs + 85 +/- 6%, respectively). L-NNA caused a greater decrease in portal tributary blood flow in portal vein stenosed and cirrhotic rats (-63 +/- 4% and -55 +/- 4%, respectively) than in normal rats (-45 +/- 6%). Similarly, the increase in portal territory vascular resistance was significantly more marked in portal vein stenosed and cirrhotic rats (+ 337 +/- 62% and + 214 +/- 24%, respectively) than in normal rats (+ 153 +/- 23%). Portal pressure did not change. Following the acute administration of L-NNA, no significant difference in splanchnic and systemic haemodynamics were noted between portal vein stenosed and normal rats, except for portal pressure. In cirrhotic rats, splanchnic and systemic values remained different from normal rats. This study confirms that NO plays a role in the haemodynamic changes in portal hypertension, and shows that NO inhibitors have a dose-dependent effect in conscious portal hypertensive rats.
一氧化氮(NO)在门静脉高压高动力循环中的作用尚未完全阐明。不同剂量的NO抑制剂、血流动力学指标和实验条件可能导致结果存在差异。本研究旨在探讨NO特异性生物合成抑制剂Nω-硝基-L-精氨酸(L-NNA)对正常清醒大鼠以及因部分门静脉狭窄或继发性胆汁性肝硬化所致门静脉高压大鼠的全身和内脏循环的急性影响。给予L-NNA(15至960微克·千克⁻¹·分钟⁻¹)可引起动脉压显著的剂量依赖性升高,三组大鼠之间无差异。给予急性最大升压剂量的L-NNA(1毫克·千克⁻¹·分钟⁻¹)后,门静脉狭窄和肝硬化大鼠的心脏指数下降幅度(分别为-45±3%和-45±2%)大于正常大鼠(-31±2%),两组门静脉高压大鼠的全身血管阻力增加幅度大于正常大鼠(分别为+161±13%和+154±10%,而正常大鼠为+85±6%)。L-NNA使门静脉狭窄和肝硬化大鼠的门静脉分支血流减少幅度(分别为-63±4%和-55±4%)大于正常大鼠(-45±6%)。同样,门静脉狭窄和肝硬化大鼠的门静脉区域血管阻力增加幅度(分别为+337±62%和+214±24%)显著大于正常大鼠(+153±23%)。门静脉压力未发生变化。急性给予L-NNA后,除门静脉压力外,门静脉狭窄大鼠与正常大鼠在内脏和全身血流动力学方面无显著差异。在肝硬化大鼠中,内脏和全身指标仍与正常大鼠不同。本研究证实NO在门静脉高压血流动力学变化中起作用,并表明NO抑制剂对清醒门静脉高压大鼠具有剂量依赖性效应。