Lin H C, Wu H L, Huang Y T, Hou M C, Lee S D, Hong C Y
Veterans General Hospital, Taipei, Taiwan.
Eur J Clin Invest. 1998 Aug;28(8):622-8. doi: 10.1046/j.1365-2362.1998.00347.x.
Octreotide and prazosin are both effective portal hypotensive drugs in the control or prevention of variceal bleeding. The present study was undertaken to investigate the haemodynamic effects of octreotide and prazosin, alone or in combination, in portal hypertensive rats.
Portal hypertension was induced by partial portal vein ligation. Portal hypertensive rats were allocated into one of the four groups-vehicle group (saline, 0.5 mL 12 h-1), octreotide group (30 micrograms kg-1 12 h-1), prazosin group (0.4 mg kg-1 12 h-1), and octreotide (30 micrograms kg-1 12 h-1) plus prazosin (0.4 mg kg-1 12 h-1) group-with eight rats in each group. Prazosin or saline was administered by gavage, whereas octreotide was administered by subcutaneous injection. The drug was given on the day of ligation and continued for 8 consecutive days. Systemic as well as splanchnic haemodynamic parameters were measured thereafter.
Portal vein-ligated rats exhibited typical hyperdynamic state compared with sham-operated rats. The portal venous pressure, portal tributary blood flow and cardiac index were significantly reduced by treatment of octreotide, prazosin or octreotide plus prazosin in portal hypertensive rats. Hyperdynamic parameters of systemic, renal and portal territory vascular resistances, and renal as well as hepatic arterial blood flow were ameliorated by treatment of octreotide or octreotide plus prazosin in portal hypertensive rats. Overall, octreotide treatment exerted more beneficial haemodynamic effects than prazosin treatment. The combination of octreotide and prazosin exerted better haemodynamic effects in cardiac index but worse effects in systemic as well as portal territory vascular resistance than octreotide treatment alone.
奥曲肽和哌唑嗪都是控制或预防静脉曲张出血的有效门脉降压药物。本研究旨在探讨奥曲肽和哌唑嗪单独或联合应用对门脉高压大鼠的血流动力学影响。
通过部分门静脉结扎诱导门脉高压。将门脉高压大鼠分为四组之一——溶剂组（生理盐水，0.5 mL 每12小时一次）、奥曲肽组（30微克/千克每12小时一次）、哌唑嗪组（0.4毫克/千克每12小时一次）和奥曲肽（30微克/千克每12小时一次）加哌唑嗪（0.4毫克/千克每12小时一次）组，每组8只大鼠。哌唑嗪或生理盐水通过灌胃给药，而奥曲肽通过皮下注射给药。药物在结扎当天给予，并持续8天。此后测量全身和内脏血流动力学参数。
与假手术大鼠相比，门静脉结扎大鼠表现出典型的高动力状态。奥曲肽、哌唑嗪或奥曲肽加哌唑嗪治疗可显著降低门脉高压大鼠的门静脉压力、门静脉分支血流和心脏指数。奥曲肽或奥曲肽加哌唑嗪治疗可改善门脉高压大鼠全身、肾和门静脉区域血管阻力以及肾和肝动脉血流的高动力参数。总体而言，奥曲肽治疗比哌唑嗪治疗产生更有益的血流动力学影响。与单独使用奥曲肽治疗相比，奥曲肽和哌唑嗪联合应用对心脏指数的血流动力学影响更好，但对全身和门静脉区域血管阻力的影响更差。
