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钙拮抗剂对清醒门静脉高压大鼠肝脏及全身血流动力学的影响。

Effects of calcium antagonists on hepatic and systemic hemodynamics in awake portal hypertensive rats.

作者信息

Nagasawa M, Kawasaki T, Yoshimi T

机构信息

Second Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan.

出版信息

J Gastroenterol. 1996 Jun;31(3):366-72. doi: 10.1007/BF02355026.

Abstract

The effects of the calcium antagonists diltiazem and nicardipine on portal pressure and splanchnic blood flow were studied in awake, unrestrained portal hypertensive rats. Portal hypertension was induced in rats by partial portal vein ligation. Hemodynamic measurements were done using the radiolabeled microsphere technique. In portal vein-ligated and sham-operated rats, intraarterial diltiazem and nicardipine reduced mean arterial pressure. No significant changes, however, were observed in portal pressure and cardiac index. In portal vein-ligated rats, diltiazem and nicardipine increased portal tributary blood flow. Portal tributary vascular resistance was also significantly decreased. The decrease in the hepatocollateral vascular resistance prevented an increase in portal pressure. In sham-operated rats, these changes were not observed. It is possible that the vascular responses to calcium antagonists are altered in portal vein-ligated rats. These findings demonstrate that the hemodynamic effects of calcium antagonists occur at two levels. First, the increase in portal tributary blood flow appears to be a selective effect on portal tributary vascular resistance. Secondly, the portal pressure does not increase in parallel with the increase in portal tributary blood flow because of a similar reduction in portocollateral vascular resistance.

摘要

在清醒、不受束缚的门静脉高压大鼠中研究了钙拮抗剂地尔硫䓬和尼卡地平对门静脉压力和内脏血流的影响。通过部分门静脉结扎诱导大鼠门静脉高压。使用放射性标记微球技术进行血流动力学测量。在门静脉结扎和假手术的大鼠中,动脉内注射地尔硫䓬和尼卡地平可降低平均动脉压。然而,门静脉压力和心脏指数未见明显变化。在门静脉结扎的大鼠中,地尔硫䓬和尼卡地平增加了门静脉分支血流。门静脉分支血管阻力也显著降低。肝侧支血管阻力的降低阻止了门静脉压力的升高。在假手术的大鼠中,未观察到这些变化。门静脉结扎的大鼠对钙拮抗剂的血管反应可能发生了改变。这些发现表明钙拮抗剂的血流动力学效应发生在两个层面。首先,门静脉分支血流的增加似乎是对门静脉分支血管阻力的选择性作用。其次,由于门体侧支血管阻力的类似降低,门静脉压力不会随门静脉分支血流的增加而平行升高。

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