Kirstetter P, Pilette C, Moreau R, Cailmail S, Safka V, Soupison T, Lebrec D
Laboratoire d'Hémodynamique Splanchnique, INSERM U-24, Hôpital Beaujon, Clichy, France.
J Gastroenterol Hepatol. 1996 Mar;11(3):230-5. doi: 10.1111/j.1440-1746.1996.tb00067.x.
The haemodynamic effects of nitrovasodilators and their mechanisms of action on portal hypertension remain unclear. The splanchnic and systemic haemodynamic response to the infusion of isosorbide dinitrate (100 micrograms/kg per min), a nitrovasodilator, was investigated in cirrhotic rats. The role of the conscious state in the haemodynamic response to isosorbide dinitrate was examined using rats that were anaesthetized with pentobarbitone. The role of sympathetic tone in the haemodynamic response to isosorbide dinitrate was examined using rats pretreated with the ganglion blocker hexamethonium. Isosorbide dinitrate had no haemodynamic effects in conscious, unblocked normal and cirrhotic rats. Isosorbide dinitrate had no haemodynamic effects in normal and cirrhotic rats treated with hexamethonium. In normal anaesthetized rats, isosorbide dinitrate significantly decreased systemic vascular resistance (414 +/- 25 vs 290 +/- 26 dyn.s/cm-5 per 100 g). In cirrhotic anaesthetized rats, isosorbide dinitrate significantly decreased mean arterial pressure (98 +/- 6 vs 79 +/- 7 mmHg), systemic vascular resistance (318 +/- 30 vs 207 +/- 10 dyn.s/cm-5 per 100 g), portal pressure (14.0 +/- 1.0 vs 11.3 +/- 0.9 mmHg) and portal territory vascular resistance (1362 +/- 163 vs 1031 +/- 182 dyn.s/cm5 per 100 g). In conclusion, this study shows that the portal hypotensive effects of isosorbide dinitrate depend upon the alterations of vascular tone by pentobarbitone.
硝基血管扩张剂的血流动力学效应及其对门静脉高压的作用机制尚不清楚。研究了肝硬化大鼠对硝血管扩张剂硝酸异山梨酯（每分钟100微克/千克）输注的内脏和全身血流动力学反应。使用戊巴比妥麻醉的大鼠研究清醒状态在对硝酸异山梨酯血流动力学反应中的作用。使用神经节阻滞剂六甲铵预处理的大鼠研究交感神经张力在对硝酸异山梨酯血流动力学反应中的作用。硝酸异山梨酯对清醒、未阻断的正常和肝硬化大鼠无血流动力学影响。硝酸异山梨酯对用六甲铵处理的正常和肝硬化大鼠无血流动力学影响。在正常麻醉大鼠中，硝酸异山梨酯显著降低全身血管阻力（每100克414±25对290±26达因·秒/厘米⁵）。在肝硬化麻醉大鼠中，硝酸异山梨酯显著降低平均动脉压（98±6对79±7毫米汞柱）、全身血管阻力（每100克318±30对207±10达因·秒/厘米⁵）、门静脉压力（14.0±1.0对11.3±0.9毫米汞柱）和门静脉区域血管阻力（每100克1362±163对1031±182达因·秒/厘米⁵）。总之，本研究表明硝酸异山梨酯的门静脉降压作用取决于戊巴比妥对血管张力的改变。
