Lin P W, Shan Y S
Department of Surgery, Medical College, National Cheng Kung University, Tainan, Taiwan, Republic of China.
Proc Natl Sci Counc Repub China B. 1995 Oct;19(4):240-5.
Hemodynamic changes and certain humoral factors possibly responsible for splanchnic hyperemia in portal hypertensive rabbits created by partial portal vein ligation were studied. Portal pressure was significantly elevated after portal vein ligation and reached a climax on the second day. Then, it decreased but still remained at a plateau in a portal hypertensive state in the following days. Portal blood flow, measured with an electromagnetic flowmeter, had no significant change immediately after portal vein ligation and on post ligation day-1, but it increased significantly from the second day. Portal venous resistance rose significantly from the basal state immediately after portal vein ligation, then, it decreased from the second day, but still remained at a high resistance level as compared with the normal (p < 0.05). The levels of prostaglandin E2 and prostacyclin in the portal vein increased immediately after portal vein ligation but decreased on the second day. However, prostacyclin rose again on the fifth day. It is apparent from this study that once portal pressure or portal resistance increases, there is a surge of prostaglandin E2 and prostacyclin in the portal blood. Due to the vasodilation effect of prostacyclin, prostaglandin E2 and other possible vasodilators, portosystemic shunts are gradually produced, and splanchnic hyperemia develops in the portal hypertension. The initial mechanism of portal hypertension in this model was due mainly to an increase in resistance. At a later stage, increased splanchnic blood flow combined with increased resistance played an important role in the maintenance of portal hypertension.
研究了部分门静脉结扎所致门静脉高压兔内脏充血可能相关的血流动力学变化及某些体液因素。门静脉结扎后门静脉压力显著升高,并在第二天达到峰值。然后,压力下降,但在接下来的几天里仍维持在门静脉高压状态的平台期。用电磁流量计测量的门静脉血流量在门静脉结扎后及结扎后第1天无显著变化,但从第二天起显著增加。门静脉阻力在门静脉结扎后立即从基础状态显著升高,然后从第二天起下降,但与正常相比仍维持在高阻力水平(p<0.05)。门静脉中前列腺素E2和前列环素水平在门静脉结扎后立即升高,但在第二天下降。然而,前列环素在第五天再次升高。从这项研究中可以明显看出,一旦门静脉压力或门静脉阻力增加,门静脉血中前列腺素E2和前列环素就会激增。由于前列环素、前列腺素E2和其他可能的血管舒张剂的血管舒张作用,逐渐产生门体分流,门静脉高压时出现内脏充血。该模型中门静脉高压的初始机制主要是阻力增加。在后期,内脏血流量增加与阻力增加共同在门静脉高压的维持中起重要作用。