Mathias C J
Department of Medicine, St Mary's Hospital/Imperial College School of Medicine, London, UK.
Fundam Clin Pharmacol. 1997;11(1):29-34. doi: 10.1111/j.1472-8206.1997.tb00165.x.
The splanchnic circulation is one of the largest vascular regions in man. In the past, this has been difficult to study because of methodological problems. The adapting of noninvasive Doppler techniques has made it possible to develop reproducible measurements of coeliac and superior mesenteric artery blood flow, which are the main contributors to the gastrointestinal vasculature. This has resulted in the further understanding of neurogenic and humoral control of this region in a number of physiological and pathophysiological states, and has contributed towards the knowledge of its pharmacological control. These studies are of relevance to cardiovascular homeostasis and, in particular, systemic blood pressure control which depends upon various factors including responses in different vascular regions. In this review the key physiological factors which influence pharmacological studies on this circulation will be discussed. Examples will be provided, in subjects with cardiovascular and neurological disorders, of how administration of endogenous and exogenous substances, including drugs with specific pharmacological effects, alter human gastrointestinal blood flow. These will include insulin, alcohol, the somatostatin analogue octreotide, the central acting sympatholytic clonidine and the angiotensin II-converting inhibitor captopril. The relevance of these studies to subjects with postural hypotension due to sympathetic denervation and to primary hypertension, in particular, will be discussed.
内脏循环是人体最大的血管区域之一。过去，由于方法学问题，对其研究一直很困难。无创多普勒技术的应用使得对腹腔干和肠系膜上动脉血流进行可重复测量成为可能，这两条动脉是胃肠道血管系统的主要供血动脉。这使得人们对该区域在多种生理和病理生理状态下的神经源性和体液性控制有了更深入的理解，并有助于了解其药理控制。这些研究与心血管稳态相关，特别是与全身血压控制相关，全身血压控制取决于多种因素，包括不同血管区域的反应。在这篇综述中，将讨论影响该循环药理研究的关键生理因素。将举例说明在患有心血管和神经系统疾病的受试者中，内源性和外源性物质（包括具有特定药理作用的药物）的给药如何改变人体胃肠道血流。这些物质将包括胰岛素、酒精、生长抑素类似物奥曲肽、中枢作用的交感神经阻滞剂可乐定和血管紧张素 II 转换酶抑制剂卡托普利。将特别讨论这些研究与因交感神经去神经支配导致体位性低血压的受试者以及原发性高血压患者的相关性。
