CO及肺泡血管壁通透性在肝硬化大鼠中的变化

Alterations in plasma carbon monoxide levels and alveolar permeability in cirrhotic rats

目的:观察CCl4诱导的肝硬化模型中,CO及肺泡血管壁通透性的变化.方法:CCl4皮下注射制备大鼠肝硬化模型,动脉插管生理多导仪记录心率、平均动脉压的变化,门静脉插管测定门静脉压力,血浆CO水平的测定用联二亚硫酸盐还原法,静脉注射伊文思蓝测定肺泡血管壁通透性.结果:CCl4成功复制肝硬化模型,显微镜下见正常肝小叶被完全破坏,有典型的假小叶形成.肺组织肺泡壁增厚,肺毛细血管管腔扩张,部分肺泡腔变小.与正常对照组相比,肝硬化组平均动脉压显著降低(15.92kPa±0.74kPavs18.93kPa±0.71kPa,P<0.01),门脉压力显著增高(16.67cmH2O±0.63cmH2Ovs8.82cmH2O±0.29cmH2O,P<0.01);血浆CO水平显著升高(18.69μmol/L±1.86μmol/Lvs10.27μmol/L±1.21μmol/L,P<0.01);肺组织EB含量明显增加(36.57μg/g±1.69μg/gvs29.83μg/g±2.34μg/g,P<0.01).结论:HO-CO的激活、肺泡血管壁通透性增加可能是肝肺综合征的重要原因.

AIM： To examine possible alterations in plasma carbon monoxide （CO） levels and alveolar permeability in rats with carbon tetrachloride- induced cirrhosis. METHODS： Liver cirrhosis was induced in rats by subcutaneous administration of carbon tet- rachloride. Mean arterial pressure （MAP, kPa）, heart rate （HR, b/min）, and portal pressure （PP, cm/H2O） were monitored by using an indwelling catheter. Plasma CO levels were determined by Chalmers method, and alveolar permeability was measured using the Evens blue extravasation technique. RESULTS： Typical features of cirrhosis were histologically observed in carbon tetrachloridetreated rats. Compared with normal control rats, cirrhotic rats presented a significant increase in portal pressure （16.67 cmH2O ± 0.63 cmH2O vs 8.82 cmH2O ± 0.29 cmH2O; P 〈 0.01）, plasma CO levels （18.69 μmol/L ± 1.86 μmol/L vs 10.27 μmol/L ± 1.21 μmol/L; P 〈 0.01）, and Evens blue extravasation （36.57 μg/g ± 1.69 μg/g vs 29.83 μg/g ± 2.34 μg/g; P 〈 0.01）, but a significant decrease in mean arterial pressure （15.92 kPa ± 0.74 kPa vs 18.93 kPa ± 0.71 kPa; P 〈 0.01）. CONCLUSION： Activation of the HO-CO system and increased alveolar permeability may be important causes of development of hepatopulmonary syndrome in patients with cirrhosis.