DSRS后肝硬化门脉高压症猪血浆去甲肾上腺素浓度的变化及意义

Change of serum noradrenalin levels in cirrhosis swine with portal hypertension after DSRS

目的:观测远端脾肾分流术(DSRS)治疗猪肝硬化门脉高压前后门静脉(PV)及脾静脉(SV)、下腔静脉(IVC)血浆中去甲肾上腺素(NA)浓度变化。方法:采用CC l4/乙醇法建立猪肝硬化门脉高压模型,开展远端脾肾分流术(DSRS),术中测量静脉压力,手术前后测定各静脉血浆NA浓度。结果:猪肝硬化门脉高压成模后,PV、SV压力及血浆NA浓度均显著升高,SV血浆NA浓度显著高于PV,IVC血浆NA浓度也显著升高。DSRS术后,SV压力显著下降,PV无明显变化,左肾静脉压力轻度升高(P<0.05)。PV、SV、IVC的血浆NA浓度也无明显变化,但SV血浆NA浓度仍显著高于PV。结论:猪肝硬变门静脉高压症存在着明显的儿茶酚胺类递质——NA的代谢紊乱,在门静脉系统内分布不均,其对全身及内脏血流动力学的影响与门静脉高压症发生发展的关系值得深入研究。

Objective： To observe the change in the level of plasma noradrenaline （NA） in blood vessels, including splenic vein（ SV）, portal vein（ PV）, inferior vena cava（IVC） in cirrhosis porcine with portal hypertension after distal splenorenal shunts （DSRS）. Methods： Animal model of portal hypertensive （PHT）porcine was induced by CCl4/ethanol, operation of distal splenorenal shunts （DSRS） was performed, free portal pressure （FPP）, Splenic vein pressure （SVP）, left renal vein pres- sureowere investigated, High Pressure Liquid chromatography （HPLC） was used to measure plasma concentration of NA in PV, SV and IVC. Results：After the formation of PHT, FPP, SVP and concentration of NA in SV, PV, IVC were significantly increased, Concentration of NA in SV was significantly higher than in PV. After DSRS was performed, left renal vein pressure increased （P 〈 0.05 ） , SV pressure were significantly decreased. Concentration of NA in SV, PV, IVC and FPP had no significant changes （ P 〉 0.05 ）. Concentration of NA in SV was significantly higher than in PV before and after DSRS （ P 〈 0.05 ）. Conclusion：Significant metabolic disorders of NA in porcine cirrhosis with PHT are obvious, which may play an important role in the pathogenesis of portal hypertension.