梗阻性黄疸兔血浆内毒素和内皮素1含量与血流动力学改变的关系

Experimental study on the plasma level or endothelin and endotoxin in rabbits with obstructive jaundiceand the correlation of endothelin with hemodynamic change

研究梗阻性黄疸内毒素血症对血管内皮细胞产生内皮素１（ＥＴ－１）的作用及ＥＴ－１与梗阻性黄应时血流动力学改变的关系。方法用肝总管结扎法建立梗阻性黄疸（ＯＪ）兔模型，偶氮显色法定量测定血内毒素含量，特异性放射免疫分析法测定血浆ＥＴ－１，生理记录仪和电磁血流计测定心率（ＨＲ）、平均动脉压（ＭＡＰ）、心输出量（ＣＯ）、肝动脉血流量（ＨＡＢＦ）、门静脉血流量（ＰＶＢＦ）、门静脉压力（ＰＶＰ）及内脏血管阻力（ＳＡＲ）。结果ＯＪ组血浆内毒素含量明显高于正常对照（ＮＣ）组；血浆ＥＴ－１低于ＮＣ组。ＯＪ组血浆内毒素与血浆ＥＴ－１含量呈负相关；ＯＪ组血浆ＥＴ－１含量与ＭＡＰ、ＨＡＢＦ、ＰＶＢＦ及ＳＡＲ呈正相关。结论梗阻性黄疽时血浆ＥＴ－１水平降低，内毒素血症不能刺激血管内皮细胞产生ＥＴ－１，血浆ＥＴ－１水平下降在系统血流动力学改变中起一定的作用。

Objective To study the induction of endotoxin to endothelin (ET) and the correlation of ET with hemodynamic changes in rabbits with obstructive jaundice. Methods Forty rabbitswere randomly divided into obstructive jaundice group (OJ, n=20) and normal control group (NC, n=20). The rabbit models of obstructive jaundice were established by ligation of hepatic duct. The plasmaET-1 and endotoxin level were determined. The HR, CO, MAP, HABF, PVBF, PVP, and SAR weremeasured by electromagnetic flowmeter and physiograph. Result ET-1 level in OJ group was lowerthan in NC group (P<0.05), and the plasma level of endotoxin in OJ was higher than in NC groupP<0. 01) after 4 weeks. ET-1 level was negatively related with MAP, HAP, HABF, PVBF and SARin OJ group. Conclusion Endotoxin could not induce the synthesis of ET-1 in obstructive iaundice andthe decrease of ET-1 might play a role in systemic hemodynamic change of obstructive jaundice.