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门脉高压性胃病发生机制的实验研究
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作者 张永模 张江南 彭贵祖 《南昌大学学报(医学版)》 CAS 1997年第2X期30-33,共4页
本实验采用二期门静脉结扎法复制大鼠门脉高压模型,测定门脉高压时大鼠胃粘膜血流量,损伤指数以及门脉血中超氧化物化酶,过氧化脂质的变化,并对其胃粘膜超微结构进行观察。结果表明:门脉高压时胃粘膜易受损害,其胃粘膜血流量增多... 本实验采用二期门静脉结扎法复制大鼠门脉高压模型,测定门脉高压时大鼠胃粘膜血流量,损伤指数以及门脉血中超氧化物化酶,过氧化脂质的变化,并对其胃粘膜超微结构进行观察。结果表明:门脉高压时胃粘膜易受损害,其胃粘膜血流量增多,但在损伤因子作用下,其血流量减少较剧,而门脉血中SOD及LPO的变化并不显著。超微结构显示:门脉高压时其毛细血管结构的完整性受到破坏。提示门脉高压时胃粘膜在损伤因子作用下血流量减少是门脉高压性胃病发生的重要原因之一,其胃粘膜毛细血管结构的完整性受到破坏可能是血流量急剧减少的病理解剖学基础,而超氧化物歧化酶对自由基的清除作用可能并不参与胃粘膜的保护作用。 展开更多
关键词 高血压.门脉 胃肠疾病 超氧化物歧化酶类 动物.实验 大鼠
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急诊门奇静脉断流术抢救食管胃底静脉破裂出血
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作者 张致琦 戴海生 安福荣 《山西医科大学学报》 CAS 1997年第S1期40-41,共2页
报告门静脉高压症合并食管胃底静脉破裂大出血23例,施行急诊门奇静脉断流术。急救和随访效果满意。认为,断流术以其简单、合理、有效在急诊处置中具有重要价值。
关键词 食管 胃底 静脉破裂 高血压.门脉
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脾切除贲门周围血管离断术48例临床体会
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作者 李章红 董大磻 王小农 《赣南医学院学报》 1994年第4期299-300,共2页
脾切除贲门周围血管离断术48例临床体会李章红,董大磻,王小农(附属医院普外科赣州341000)关键词脾切除术;高血压.门脉/外科手术;食管静脉曲张/外科手术脾切除、贲门周围血管离断术是门脉高压症断流术的一种术式,我们... 脾切除贲门周围血管离断术48例临床体会李章红,董大磻,王小农(附属医院普外科赣州341000)关键词脾切除术;高血压.门脉/外科手术;食管静脉曲张/外科手术脾切除、贲门周围血管离断术是门脉高压症断流术的一种术式,我们自1985~1993年对48例门脉... 展开更多
关键词 脾切除术 高血压.门脉/外科手术 食管静脉曲张/外科手术
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Effect of endotoxin on portal hemodynamic in rats 被引量:9
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作者 BiXJ ChenMH 《World Journal of Gastroenterology》 SCIE CAS CSCD 2002年第3期528-530,共3页
AIM: To study the effects of endotoxin on portal hemodynamic of normal and noncirrhotic portal hypertensive rats. METHODS: Normal rats were intraperitoneally injected with 0.1, 0.25, 0.5, 1.0, 2.0, 4.0mg.kg(-1) of lip... AIM: To study the effects of endotoxin on portal hemodynamic of normal and noncirrhotic portal hypertensive rats. METHODS: Normal rats were intraperitoneally injected with 0.1, 0.25, 0.5, 1.0, 2.0, 4.0mg.kg(-1) of lipopolysaccharide(LPS) respectively, portal vein ligation(PVL) and intrahepatic portal occlusion (IPO) rats as well as sham-operated rats were treated with an intraperitoneal injection of 1.0mg.kg(-1) of LPS, the portal vein pressure(PVP), portal venous flow(PVF), inferior vena cava pressure(IVCP) and portal vein resistance(PVR) were detected 4 hours after injection. RESULTS: PVF of the 5 groups of rats accepting intraperitoneal injection of LPS were increased from 14.0 to 18.0, 22.2, 26.2, 34.8, 39.6, 38.8 mL.min(-1) 4 hours after injection of LPS(P【0.01). PVP of the 4 groups of rats accepting more than 0.1mg/kg.b.w of LPS was increased from 1.04 to 1.25, 1.50, 1.80, 1.95, 2.05 kPa(P【0.01). The increments of PVF and PVP were in a dose-dependent manner of LPS. PVR of the 5 groups of rats was decreased from 51 to 42,44,48,45,44,47 kPa.min.L(-1) (P【0.05) and no dose-dependent manner was observed. PVF of PVL, IPO and sham-operated rats increased from 22.6 to 32.8, 22.0 to 28.0, 14.0 to 34.8 mL.min(-1) (P【0.01), and PVP increased from 1.86 to 2.24, 1.74 to 1.95, 1.04 to 1.80 kPa(P【0.01), PVR decreased from 71 to 61, 67 to 61, 52 to 44 kPa.min.L(-1) after intraperitoneal injection of 1mg.kg(-1) of LPS. The increments of PVF and PVP of PVL and IPO rats were significantly less than the sham-operated rats(P【0.01), There was no significant difference between the amounts of PVR decreased in the two groups of PHT model rats and sham-operated rats(P】0.05) after intraperitoneal injection 1mg.kg(-1) of LPS. CONCLUSION: Endotoxin could prompt portal hypertension of the normal and noncirrhotic portal hypertensive rats by increasing portal blood flow mainly. 展开更多
关键词 Animals Disease Models Animal Female Hemodynamic Processes Hypertension Portal LIPOPOLYSACCHARIDES Portal System RATS Rats Sprague-Dawley
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Stability of a rat model of prehepatic portal hypertension caused by partial ligation of the portal vein 被引量:8
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作者 Zhe Wen Jin-Zhe Zhang +2 位作者 Hui-Min Xia Chun-Xiao Yang Ya-Jun Chen 《World Journal of Gastroenterology》 SCIE CAS CSCD 2009年第32期4049-4054,共6页
AIM: To study the stability of portal hypertension (PHT) caused by partial ligation of the portal vein ligation (PVL) in a rat model.METHODS: Thirty male adult Wistar rats were divided into two groups: 10 in Gr... AIM: To study the stability of portal hypertension (PHT) caused by partial ligation of the portal vein ligation (PVL) in a rat model.METHODS: Thirty male adult Wistar rats were divided into two groups: 10 in Group Ⅰ received a sham operation; and 20 in Group Ⅱreceived partial PVL. Portal vein pressure (PVP) was measured at four time periods: before ligation, 2 wk, 6 wk and 10 wk postsurgery. Portal venography, blood sampling and liver and spleen pathological examinations were conducted at 10 wk after surgery.RESULTS: The PVP was 9.15± 0.58 cmH2O before ligation, and increased to 17.32 ±0.63 cmH2O 2 wk after PVL. By repeat measurement of the PVP in each rat, it was shown to remain elevated for 10 wk. There were no significant differences in the pressure measurements at 2 wk, 6 wk and 10 wk. Varices were found mainly in the mesenteric vein 2 wk after PVL, which were more obvious later, while these manifestations were similar at week 6 and week 10. Portal venography demonstrated the varices and collaterals. There was no significant change in liver pathology. The volume of the spleen was enlarged 2-fold after ligation, and the sinus of the spleen was enlarged due to congestion. Significant sinus endothelial cell proliferation was observed, but no evidence of hypersplenia was found on hemogram and biochemical examination.CONCLUSION: These findings suggest that a satisfactory prehepatic PHT rat model can be obtained by partial ligation of the portal vein, and this PHT rat model was stable for at least 10 wk. 展开更多
关键词 LIGATION Portal hypertension Portal vein RAT
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Effect of transjugular intrahepatic portosystemic shunt on pulmonary gas exchange in patients with portal hypertension and hepatopulmonary syndrome 被引量:12
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作者 Graciela Martínez-Pallí Britt B Drake +5 位作者 Joan-Carles García-Pagán Joan-Albert Barberà Miguel R Arguedas Robert Rodriguez-Roisin Jaume Bosch Michael B Fallon 《World Journal of Gastroenterology》 SCIE CAS CSCD 2005年第43期6858-6862,共5页
AIM: To assess the impact of transjugular intrahepatic portosystemic shunt (TIPS) on pulmonary gas exchange and to evaluate the use of TIPS for the treatment of hepatopulmonary syndrome (HPS).METHODS: Seven patients, ... AIM: To assess the impact of transjugular intrahepatic portosystemic shunt (TIPS) on pulmonary gas exchange and to evaluate the use of TIPS for the treatment of hepatopulmonary syndrome (HPS).METHODS: Seven patients, three of them with advanced HPS, in whom detailed pulmonary function tests were performed before and after TIPS placementat the University of Alabama Hospital and at the Hospital Clinic, Barcelona, were considered.RESULTS: TIPS patency was confirmed by hemodynamic evaluation. No changes in arterial blood gases were observed in the overall subset of patients. Transient arterial oxygenation improvement was observed in only one HPS patient, early after TIPS, but this was not sustained 4 mo later.CONCLUSION: TIPS neither improved nor worsened pulmonary gas exchange in patients with portal hypertension. This data does not support the use of TIPS as a specific treatment for HPS. However, it does reinforce the view that TIPS can be safely performed for the treatment of other complications of portal hypertension in patients with HPS. 展开更多
关键词 Portal hypertension Transjugular intrahepaticportosystemic shunt Pulmonary gas exchange Hepatopulmonary syndrome
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Staging of portal hypertension and portosystemic shunts using dynamic nuclear medicine investigations 被引量:7
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作者 Mircea Dragoteanu Ioan A Balea +4 位作者 Liliana A Dina Cecilia D Piglesan Ioana Grigorescu Stefan Tamas Sabin O Cotul 《World Journal of Gastroenterology》 SCIE CAS CSCD 2008年第24期3841-3848,共8页
AIM: To explore portal hypertension and portosystemic shunts and to stage chronic liver disease (CLD) based on the pathophysiology of portal hemodynamics. METHODS: Per-rectal portal scintigraphy (PRPS) was perfo... AIM: To explore portal hypertension and portosystemic shunts and to stage chronic liver disease (CLD) based on the pathophysiology of portal hemodynamics. METHODS: Per-rectal portal scintigraphy (PRPS) was performed on 312 patients with CLD and liver angioscintigraphy (LAS) on 231 of them. The control group included 25 healthy subjects. We developed a new model of PRPS interpretation by introducing two new parameters, the liver transit time (LTT) and the circu-lation time between right heart and liver (RHLT). LTT for each lobe was used to evaluate the early portal hypertension. RHLT is useful in cirrhosis to detect liver areas missing portal inflow. We calculated the classical per-rectal portal shunt index (PRSI) at PRPS and the hepatic perfusion index (HPI) at LAS. RESULTS: The normal LTT value was 24 ± 1 s. Abnormal LTT had PPV = 100% for CLD. Twenty-seven noncirrhotic patients had LTT increased up to 35 s (median 27 s). RHLT (42 ± 1 s) was not related to liver disease. Cirrhosis could be excluded in all patients with PRSI 〈 5% (P 〈 0.01). PRSI 〉 30% had PPV = 100% for cirrhosis. Based on PRPS and LAS we propose the classification of CLD in 5 hemodynamic stages. Stage 0 is normal (LTT = 24 s, PRSI 〈 5%). In stage 1, LTT is increased, while PRSI remains normal. In stage 2, LTT is decreased between 16 s and 23 s, whereas PRSI is increased between 5% and 10%. In stage 3, PRSI is increased to 10%-30%, and LTT becomes undetectable by PRPS due to the portosystemic shunts. Stage 4 includes the patients with PRSI 〉 30%. RHLT and HPI were used to subtype stage 4. In our study stage 0 had NPV = 100% for CLD, stage 1 had PPV = 100% for non-cirrhotic CLD, stages 2 and 3 represented the transition from chronic hepatitis to cirrhosis, stage 4 had PPV = 100% for cirrhosis. CONCLUSION: LTT allows the detection of early portal hypertension and of opening of transhepatic shunts. PRSI is useful in CLD with extrahepatic portosystemic shunts. Our hemodynamic model stages the evolution of portal hypertension and portosystemic shunts. It may be of use in the selection of patients for interferon therapy. 展开更多
关键词 Chronic liver disease Portal hypertension Portosystemic shunts Per-rectal portal scintigraphy Angioscintigraphy
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Portal hypertension due to portal venous thrombosis:Etiology, clinical outcomes 被引量:21
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作者 Ozgur Harmanci Yusuf Bayraktar 《World Journal of Gastroenterology》 SCIE CAS CSCD 2007年第18期2535-2540,共6页
The thrombophilia in adult life has major implications in the hepatic vessels. The resulting portal vein thrombosis has various outcomes and complications. Esophageal varices, portal gastropathy, ascites, severe hyper... The thrombophilia in adult life has major implications in the hepatic vessels. The resulting portal vein thrombosis has various outcomes and complications. Esophageal varices, portal gastropathy, ascites, severe hypersplenism and liver failure needing liver transplantation are known well. The newly formed collateral venous circulation showing itself as pseudocholangicarcinoma sign and its possible clinical reflection as cholestasis are also known from a long time. The management strategies for these complications of portal vein thrombosis are not different from their counterpart which is cirrhotic portal hypertension, but the prognosis is unquestionably better in former cases. In this review we present and discuss the portal vein thrombosis, etiology and the resulting dinical pictures. There are controversial issues in nomenclature, management (including anticoagulation problems), follow up strategies and liver transplantation. In the light of the current knowledge, we discuss some controversial issues in literature and present our experience and our proposals about this group of patients. 展开更多
关键词 Portal vein thrombosis Pseudocholangiocarcinomasign Thrombophilia
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Wall shear stress in portal vein of cirrhotic patients with portal hypertension 被引量:6
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作者 Wei Wei Yan-Song Pu +7 位作者 Xin-Kai Wang An Jiang Rui Zhou Yu Li Qiu-Juan Zhang Ya-Juan Wei Bin Chen Zong-Fang Li 《World Journal of Gastroenterology》 SCIE CAS 2017年第18期3279-3286,共8页
AIM To investigate wall shear stress(WSS) magnitude and distribution in cirrhotic patients with portal hypertension using computational fluid dynamics. METHODS Idealized portal vein(PV) system models were reconstructe... AIM To investigate wall shear stress(WSS) magnitude and distribution in cirrhotic patients with portal hypertension using computational fluid dynamics. METHODS Idealized portal vein(PV) system models were reconstructed with different angles of the PV-splenic vein(SV) and superior mesenteric vein(SMV)-SV. Patient-specific models were created according to enhanced computed tomography images. WSS was simulated by using a finite-element analyzer, regarding the blood as a Newtonian fluid and the vessel as a rigid wall. Analysis was carried out to compare the WSSin the portal hypertension group with that in healthy controls.RESULTS For the idealized models, WSS in the portal hypertension group(0-10 dyn/cm2) was significantly lower than that in the healthy controls(10-20 dyn/cm2), and low WSS area(0-1 dyn/cm2) only occurred in the left wall of the PV in the portal hypertension group. Different angles of PV-SV and SMV-SV had different effects on the magnitude and distribution of WSS, and low WSS area often occurred in smaller PV-SV angle and larger SMV-SV angle. In the patient-specific models, WSS in the cirrhotic patients with portal hypertension(10.13 ± 1.34 dyn/cm2) was also significantly lower than that in the healthy controls(P < 0.05). Low WSS area often occurred in the junction area of SV and SMV into the PV, in the area of the division of PV into left and right PV, and in the outer wall of the curving SV in the control group. In the cirrhotic patients with portal hypertension, the low WSS area extended to wider levels and the magnitude of WSS reached lower levels, thereby being more prone to disturbed flow occurrence.CONCLUSION Cirrhotic patients with portal hypertension show dramatic hemodynamic changes with lower WSS and greater potential for disturbed flow, representing a possible causative factor of PV thrombosis. 展开更多
关键词 Portal hypertension Wall shear stress Portal vein system DISTRIBUTION Disturbed flow
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Clinical analysis of surgical treatment of portal hypertension 被引量:15
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作者 Xin-Bao Xu Jing-Xiu Cai +7 位作者 Xi-Sheng Leng Jia-Hong Dong Ji-Ye Zhu Zhen-Ping He Fu-Shun Wang Ji-Run Peng Ben-Li Han Ru-Yu Du 《World Journal of Gastroenterology》 SCIE CAS CSCD 2005年第29期4552-4559,共8页
AIM: To review the experience in surgery for 508 patients with portal hypertension and to explore the selection of reasonable operation under different conditions. METHODS: The data of 508 patients with portal hyper... AIM: To review the experience in surgery for 508 patients with portal hypertension and to explore the selection of reasonable operation under different conditions. METHODS: The data of 508 patients with portal hypertension treated surgically in 1991-2001 in our centers were analyzed. Of the 508 patients, 256 were treated with portaazygous devascularization (PAD), 167 with portasystemic shunt (PSS), 62 with selective shunt (SS), 11 with combined portasystemic shunt and portaazygous devascularization (PSS+PAD), 9 with liver transplantation (LT), 3 with union operation for hepatic carcinoma and portal hypertension (HCC+PH). RESULTS: In the 167 patients treated with PSS, free portal pressure (FPP) was significantly higher in the patients with a longer diameter of the anastomotic stoma than in those with a shorter diameter before the operation (P〈0.01). After the operation, FPP in the former patients markedly decreased compared to the latter ones (P〈0.01). The incidence rate of hemorrhage in patients treated with PAD, PSS, 55, PSS+PAD, and HCC+PH was 21.09% (54/256), 13.77 (23/167), 11.29 (7/62), 36.36% (4/11), and 100% (3/3), respectively. The incidence rate of hepatic encephalopathy was 3.91% (10/256), 9.58% (16/167), 4.84% (3/62), 9.09% (1/11), and 100% (3/3), respectively while the operative mortality was 5.49% (15/256), 4.22% (7/167), 4.84% (3/62), 9.09% (1/11), and 66.67% (2/3) respectively. The operative mortality of liver transplantation was 22.22% (2/9). CONCLUSION: Five kinds of operation in surgical treatment of portal hypertension have their advantages and disadvantages. Therefore, the selection of operation should be based on the actual needs of the patients. 展开更多
关键词 Portal hypertension Surgical operation SHUNT
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Portal hypertensive duodenal polyp:A case report 被引量:4
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作者 Jean-David Zeitoun Ariane Chryssostalis +3 位作者 Benoit Terris Frederic Prat Marianne Gaudric Stanislas Chaussade 《World Journal of Gastroenterology》 SCIE CAS CSCD 2007年第9期1451-1452,共2页
Abnormalities of gastric mucosa in patients with portal hypertension are well documented. Manifestations of portal hypertension in small bowel and colon are less common. Colonic polypoid lesions microscopically consis... Abnormalities of gastric mucosa in patients with portal hypertension are well documented. Manifestations of portal hypertension in small bowel and colon are less common. Colonic polypoid lesions microscopically consisting of a normal mucosa, with dilatation of submucosal vessels, have been described. We here report the first case of portal hypertensive duodenal polyp, responsible for gastro-intestinal bleeding. Endoscopic treatment turned out to be successful. 展开更多
关键词 Gastrointestinal bleeding CIRRHOSIS Portal hypertension Small bowell ENDOSCOPY
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Role of PGI_2 in the formation and maintenance of hyperdynamic circulatory state of portal hypertensive rats 被引量:2
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作者 Zhi-YongWu Xue-SongChen Jiang-FengQiu HuiCao 《World Journal of Gastroenterology》 SCIE CAS CSCD 2005年第5期752-755,共4页
AIM: To investigate the role of prostacyclin (PGI2) and nitric oxide (NO) in the development and maintenance of hyperdynamic circulatory state of chronic portal hypertensive rats. METHODS: Ninety male Sprague-Dawley r... AIM: To investigate the role of prostacyclin (PGI2) and nitric oxide (NO) in the development and maintenance of hyperdynamic circulatory state of chronic portal hypertensive rats. METHODS: Ninety male Sprague-Dawley rats were divided into three groups: intrahepatic portal hypertension (IHPH) group by injection of CCI4, prehepatic portal hypertension (PHPH) group by partial stenosis of the portal vein and sham-operation control (SO) group. One week after the models were made, animals in each group were subdivided into 4 groups: saline controlled group (n = 23), Nω-nitro-L-arginine (L-NNA)group (n = 21) group, indomethacin (INDO) group (n = 22) and high-dose heparin group (n = 24). The rats were administrated 1mL of saline, L-NNA (3.3 mg/kg-d) and INDO (5 mg/kg·d) respectively through gastric tubes for one week/then heparin (200 IU/Kg/min) was given to rats by intravenous injection for an hour. Splanchnic and systemic hemodynamics were measured using radioactive microsphere techniques. The serum nitrate/nitrite(NO2-/NO3-) levels as a marker of production of NO were assessed by a colorimetric method, and concentration of 6-keto-PGF1α, a stable hydrolytic product of PGI2, was determined by radioimmunoassay. RESULTS: The concentrations of plasma 6-keto-PGFla (pg/mL) and serum NO2-/NO3- (μmol/L) in IHPH rats (1123.85±153.64, 73.34±4.31) and PHPH rats (891.88±83.11, 75.21±6.89) were significantly higher than those in SO rats (725.53±105.54, 58.79±8.47) (P<0.05). Compared with SO rats, total peripheral vascular resistance (TPR) and spanchnic vascular resistance (SVR) decreased but cardiac index (CI) and portal venous inflow (PVI) increased obviously in IHPH and PHPH rats (P<0.05). L-NNA and indomethacin could decrease the concentrations of plasma 6-keto-PGFla and serum NO2/7NO3-in IHPH and PHPH rats (P<0.05) .Meanwhile, CI, FPP and PVI lowered but MAP, TPR and SVR increased(P<0.05). After deduction of the action of NO, there was no significant correlation between plasma PGI2 level and hemodynamic parameters such as CI, TPR, PVI and SVR. However, after deduction of the action of PGI2, NO still correlated highly with the hemodynamic parameters, indicating that there was a close correlation between NO and the hemodynamic parameters. After administration of high-dose heparin, plasma 6-keto- concentrations in IHPH, PHPH and SO rats were significantly higher than those in rats administrated vehicle (P<0.05). On the contrary, levels of serum NO2-/NO3- in IHPH, PHPH and SO rats were significantly lower than those in rats administrated Vehicle (P<0.05). Compared with those rats administrated vehicle, the hemodynamic parameters of portal hypertensive rats, such as CI and PVI, declined significantly after administration of high-dose heparin (P<0.05), while TPR and SVR increased significantly (P<0.05). CONCLUSION: It is NO rather than PGI2 that is a mediator in the formation and maintenance of hyperdynamic circulatory state of chronic portal hypertensive rats. 展开更多
关键词 Portal hypertension PROSTACYCLIN Nitric oxide Hyperdynamic circulatory
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Serum omentin and vaspin levels in cirrhotic patients with and without portal vein thrombosis 被引量:1
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作者 Michal Kukla Marek Waluga +8 位作者 Michal Zorniak Agnieszka Berdowska Piotr Wosiewicz Tomasz Sawczyn Rafal J Buldak Marek Ochman Katarzyna Ziora Tadeusz Krzemiński Marek Hartleb 《World Journal of Gastroenterology》 SCIE CAS 2017年第14期2613-2624,共12页
AIMTo investigate serum omentin and vaspin levels in cirrhotic patients; and to assess the relationship of these levels with hemostatic parameters, metabolic abnormalities, cirrhosis severity and etiology.METHODSFifty... AIMTo investigate serum omentin and vaspin levels in cirrhotic patients; and to assess the relationship of these levels with hemostatic parameters, metabolic abnormalities, cirrhosis severity and etiology.METHODSFifty-one cirrhotic patients (17 with portal vein thrombosis) were analyzed. Serum omentin and vaspin levels were measured with commercially available direct enzyme-linked immunosorbent assays (ELISAs). To assess platelet activity, the following tests were performed using a MULTIPLATE<sup>®</sup>PLATELET FUNCTION ANALYZER: (1) an ADP-induced platelet activation test; (2) a cyclooxygenase dependent aggregation test (ASPI test); (3) a von Willebrand factor and glycoprotein Ib-dependent aggregation (using ristocetin) test (RISTO test); and (4) a test for thrombin receptor-activating peptide-6 induced activation of the thrombin receptor, which is sensitive to IIb/IIIa receptor antagonists.RESULTSOmentin, but not vaspin, serum concentrations were significantly decreased in patients with portal vein thrombosis (PVT) (P = 0.01). Prothrombin levels were significantly increased in patients with PVT (P = 0.01). The thrombin receptor activating peptide (TRAP) test results were significantly lower in the PVT group (P = 0.03). No significant differences in adipokines serum levels were found regarding the etiology or severity of liver cirrhosis assessed according to the Child-Pugh or Model of End-Stage Liver Disease (MELD) scores. There was a significant increase in the TRAP (P = 0.03), ASPI (P = 0.001) and RISTO high-test (P = 0.02) results in patients with lower MELD scores. Serum omentin and vaspin levels were significantly down-regulated in patients without insulin resistance (P = 0.03, P = 0.02, respectively). A positive relationship between omentin and vaspin levels were found both when all of the patients were analyzed (r = 0.41, P = 0.01) and among those with PVT (r = 0.94, P < 0.001).CONCLUSIONSerum omentin levels are increased in patients without PVT. Cirrhosis origin and grade do not affect omentin and vaspin levels. The analyzed adipokines do not influence platelet activity. 展开更多
关键词 Omentin VASPIN CIRRHOSIS ADIPOKINE Portal vein thrombosis Portal hypertension
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Splenectomy with endoscopic variceal ligation is superior to splenectomy with pericardial devascularization in treatment of portal hypertension 被引量:4
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作者 Nan Lin Bo Liu Rui-Yun Xu He-Ping Fang Mei-Hai Deng 《World Journal of Gastroenterology》 SCIE CAS CSCD 2006年第45期7375-7379,共5页
AIM: To investigate the therapeutic efficacy and complications of splenectomy with endoscopic variceal ligation (EVL) and splenectomy with pericardial devascularization (i.e. Hassab’s operation) in patients with port... AIM: To investigate the therapeutic efficacy and complications of splenectomy with endoscopic variceal ligation (EVL) and splenectomy with pericardial devascularization (i.e. Hassab’s operation) in patients with portal hypertension. METHODS: A total of 103 patients with liver cirrhosis and portal hypertension were randomly selected to receive either splenectomy with EVL (n = 53, group A) or Hassab’s operation (n = 50, group B). RESULTS: The portal blood flow volume, the presence of portal vein thrombosis, gastric emptying time and free portal venous pressure (FPP) before and after the operation were determined. Patients were followed up for up to 64 mo with an average of 45 mo, and the Dagradi classification of variceal veins and the grading of portal hypertension gastropathy (PHG) were evaluated. It was found that all esophageal varices were occluded or decreased to grade Ⅱ or less in both groups. There was little difference in the recurrence rate of esophageal varices (11.9% vs 13.2%) and the re-bleeding rate (7.1% vs 5.3%) between groups A and B. The incidence of complications and the percentage of patients with severe PHG after the operation were significantly higher in group B (60.0% and 52.0%) than in group A (32.1% and 20.8%, P < 0.05). No patients died of operation-related complications. There was no significant difference in gastric emptying time, FPP and portal blood flow volume between the two groups. CONCLUSION: The results suggest that splenectomy with EVL achieves similar therapeutic efficacy to that of Hassab’s operation in terms of the recurrence rate of esophageal varices and the re-bleeding rate, but theformer results in fewer and milder complications. 展开更多
关键词 Portal hypertension SPLENECTOMY Endoscopic varices ligation Hassab's operation
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Altered blood-brain barrier permeability in rats with prehepatic portal hypertension turns to normal when portal pressure is lowered 被引量:3
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作者 Francisco Eizayaga Camila Scorticati +5 位作者 Juan P Prestifilippo Salvador Romay Maria A Fernandez José L Castro Abraham Lemberg Juan C Perazzo 《World Journal of Gastroenterology》 SCIE CAS CSCD 2006年第9期1367-1372,共6页
AIM: To study the blood-brain barrier integrity in prehepatic portal hypertensive rats induced by partial portal vein ligation, at 14 and 40 dafer ligation when portal pressure is spontaneously normalized. METHODS: ... AIM: To study the blood-brain barrier integrity in prehepatic portal hypertensive rats induced by partial portal vein ligation, at 14 and 40 dafer ligation when portal pressure is spontaneously normalized. METHODS: Adult male Wistar rats were divided into four groups: Group Ⅰ: Sham14d, sham operated; Group Ⅱ: PHil, portal vein stenosis, (both groups were used 14 days after surgery); Group Ⅲ: Sham4od, Sham operated and Group Ⅳ: PH4od Portal vein stenosis (Groups Ⅱ and Ⅳ used 40 d afer surgery). Plasma ammonia, plasma and cerebrospinal fluid protein and liver enzymes concentrations were determined. Trypan and Evans blue dyes, systemically injected, were investigated in hippocampus to study blood-brain barrier integrity. Portal pressure was periodically recorded. RESULTS: Forty days afer stricture, portal pressure was normalized, plasma ammonia was moderately high, and both dyes were absent in central nervous system parenchyma. All other parameters were reestablished. When portal pressure was normalized and ammonia level was lowered, but not normal, the altered integrity of blood-brain barrier becomes reestablished. CONCLUSION: The impairment of blood-brain barrier and subsequent normalization could be a mechanism involved in hepatic encephalopathy reversibility. Hemodynamic changes and ammonia could trigger blood-brain barrier alterations and its reestablishment. 展开更多
关键词 Blood-brain barrier RATS Prehepatic portal hypertension
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A large congenital and solitary intrahepatic arterioportal fistula in an old woman 被引量:7
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作者 Zhen-Ya Lu Jian-Yang Ao +2 位作者 Tian-An Jiang Zhi-Yi Peng Zhan-Kun Wang 《World Journal of Gastroenterology》 SCIE CAS CSCD 2009年第13期1656-1659,共4页
Arterioportal fistula(APF)is a rare cause of portal hypertension and may lead to death.APF can be congenital,post-traumatic,iatrogenic(transhepatic intervention or biopsy)or related to ruptured hepatic artery aneurysm... Arterioportal fistula(APF)is a rare cause of portal hypertension and may lead to death.APF can be congenital,post-traumatic,iatrogenic(transhepatic intervention or biopsy)or related to ruptured hepatic artery aneurysms.Congenital APF is a rare condition even in children.In this case report,we describe a 73-year-old woman diagnosed as APF by ultrasonography,computed tomography,and hepatic artery selective arteriography.The fistula was embolized twice but failed,and she still suffered from alimentary tract hemorrhage.Then,selective arteriography of the hepatic artery was performed again and venae coronaria ventriculi and short gastric vein were embolized.During the 2-year follow-up,the patient remained asymptomatic.We therefore argue that embolization of venae coronaria ventriculi and short gastric vein may be an effective treatment modality for intrahepatic APF with severe upper gastrointestinal bleeding. 展开更多
关键词 Congenital intrahepatic arterioportal fistula Liver EMBOLIZATION Portal hypertension ANGIOGRAPHY
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Hyperammonemia,brain edema and blood-brain barrier alterations in prehepatic portal hypertensive rats and paracetamol intoxication 被引量:5
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作者 Camila Scorticati Juan P.Prestifilippo +5 位作者 Francisco X.Eizayaga Salvador Romay MaríaA Fernández AbrahamLemberg Juan C.Perazzo José L.Castro 《World Journal of Gastroenterology》 SCIE CAS CSCD 2004年第9期1321-1324,共4页
AIM:To study the blood-brain barrier integrity,brain edema, animal behavior and ammonia plasma levels in prehepatic portal hypertensive rats with and without acute liver intoxication. METHODS:Adults male Wistar rats w... AIM:To study the blood-brain barrier integrity,brain edema, animal behavior and ammonia plasma levels in prehepatic portal hypertensive rats with and without acute liver intoxication. METHODS:Adults male Wistar rats were divided into four groups.Group Ⅰ:sham operation;Ⅱ:Prehepatic portal hypertension,produced by partial portal vein ligation;Ⅲ: Acetaminophen intoxication and Ⅳ:Prehepatic portal hypertension plus acetaminophen.Acetaminophen was administered to produce acute hepatic injury.Portal pressure,liver serum enzymes and ammonia plasma levels were determined.Brain cortex water content was registered and trypan blue was utilized to study blood brain barrier integrity.Reflexes and behavioral tests were recorded. RESULTS:Portal hypertension was significantly elevated in groups Ⅱ and Ⅳ.Uver enzymes and ammonia plasma levels were increased in groups Ⅱ,Ⅲ and Ⅳ.Prehepatic portal hypertension (group Ⅱ),acetaminophen intoxication (group Ⅲ) and both (group Ⅳ) had changes in the blood brain-barrier integrity (trypan blue) and hyperammonemia.Cortical edema was present in rats with acute hepatic injury in groups Ⅲ and Ⅳ.Behavioral test (rota rod) was altered in group Ⅳ. CONCLUSION:These results suggest the possibility of another pathway for cortical edema production because blood brain barrier was altered (vasogenic) and hyperammonemia was registered (oltotoxic).Group Ⅳ,with behavioral altered test,can be considered as a model for study at an early stage of portal-systemic encephalopathy. 展开更多
关键词 Acetaminophen Analgesics Non-Narcotic Animals Behavior Animal Blood-Brain Barrier Brain Edema Humans HYPERAMMONEMIA Hypertension Portal Liver Male RATS Rats Wistar
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Multiple esophageal variceal ruptures with massive ascites due to myelofibrosis-induced portal hypertension 被引量:5
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作者 Koichi Tokai Hiroyuki Miyatani +1 位作者 Yukio Yoshida Shigeki Yamada 《World Journal of Gastroenterology》 SCIE CAS CSCD 2012年第28期3770-3774,共5页
A 75-year old man had been diagnosed at 42 years of age as having polycythemia vera and had been monitored at another hospital. Progression of anemia had been recognized at about age 70 years, and the patient was thus... A 75-year old man had been diagnosed at 42 years of age as having polycythemia vera and had been monitored at another hospital. Progression of anemia had been recognized at about age 70 years, and the patient was thus referred to our center in 2008 where secondary myelofibrosis was diagnosed based on bone marrow biopsy findings. Hematemesis due to rupture of esophageal varices occurred in January and February of 2011. The bleeding was stopped by endoscopic variceal ligation. Furthermore, in March of the same year, hematemesis recurred and the patient was transported to our center. He was in irreversible hemorrhagic shock and died. The autopsy showed severe bone marrow fibrosis with mainly argyrophilic fibers, an observation consistent with myelofibrosis. The liver weighed 1856 g the spleen 1572 g, indicating marked hepatosplenomegaly. The liver and spleen both showed extramedullary hemopoiesis. Myelofibrosis is often complicated by portal hypertension and is occasionally associated with gastrointestinal hemorrhage due to esophageal varices. A patient diagnosed as having myelofibrosis needs to be screened for esophageal/gastric varices. Myelofibrosis has a poor prognosis. Therefore, it is necessary to carefully decide the therapeutic strategy in consideration of the patient's concomitant conditions, treatment invasiveness and quality of life. 展开更多
关键词 MYELOFIBROSIS Portal hypertension Rupture of esophageal varices
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Adrenomedullin in cirrhotic and non-cirrhotic portal hypertension 被引量:5
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作者 V Tahan E Avsar +9 位作者 C Karaca E Uslu F Eren S Aydin H Uzun HO Hamzaoglu F Besisik C Kalayci A Okten N Tozun 《World Journal of Gastroenterology》 SCIE CAS CSCD 2003年第10期2325-2327,共3页
AIM:Adrenomedullin (ADM) is a potent vasodilator peptide. ADM and nitric oxide (NO) are produced in vascular endothelial cells.Increased ADM level has been linked to hyperdynamic circulation and arterial vasodilatatio... AIM:Adrenomedullin (ADM) is a potent vasodilator peptide. ADM and nitric oxide (NO) are produced in vascular endothelial cells.Increased ADM level has been linked to hyperdynamic circulation and arterial vasodilatation in cirrhotic portal hypertension (CPH).The role of ADM in non-cirrhotic portal hypertension (NCPH) is unknown,plasma ADM levels were studied in patients with NCPH,compensated and decompensated cirrhosis in order to determine its contribution to portal hypertension (PH) in these groups. METHODS:There were 4 groups of subjects.Group 1 consisted of 27 patients (F/M:12/15) with NCPH due to portal and/or splenic vein thrombosis (mean age:41±12 years),group 2 consisted of 14 patients (F/M:6/8) with compensated (Child-Pugh A) cirrhosis (mean age:46±4), group 3 consisted of 16 patients (F/M:6/10) with decompensated (Child-Pugh C) cirrhosis (mean age:47±12). Fourteen healthy subjects (F/M:6/8) (mean age:44±8) were used as controls in Group 4.ADM level was measured by ELISA.NO was determined as nitrite/nitrate level by chemoluminescence. RESULTS:ADM level in Group 1 (236±61.4 pg/mL) was significantly higher than that in group 2 (108.4±28.3 pg/mL) and group 4 (84.1±31.5 pg/mL) (both P<0.0001) but was lower than that in Group3 (324±93.7 pg/mL) (P=0.002).NO level in group 1 (27±1.4 μmol/L) was significantly higher than that in group 2 (19.8±2.8 μmol/L) and group 4 (16.9±1.6 μmol/L) but was lower than that in Group 3 (39±3.6 μmol/L) (for all three P<0.0001).A strong correlation was observed between ADM and NO levels (r=0.827,P<0.0001). CONCLUSION:Adrenomedullin and NO levels were high in both non-cirrhotic and cirrhotic portal hypertension and were closely correlated,Adrenomedullin and NO levels increased proportionally with the severity of cirrhosis,and were significantly higher than those in patients with NCPH. Portal hypertension plays an important role in the increase of ADM and NO.Parenchymal damage in cirrhosis may contribute to the increase in these parameters. 展开更多
关键词 Adult Comparative Study Female Humans Hypertension Portal Liver Cirrhosis Male Middle Aged NITRATES Nitric Oxide NITRITES PEPTIDES VASODILATION
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Presence of columnar-lined esophagus is negatively associated with the presence of esophageal varices in Japanese alcoholic men 被引量:1
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作者 Akira Yokoyama Kenro Hirata +5 位作者 Rieko Nakamura Tai Omori Takeshi Mizukami Junko Aida Katsuya Maruyama Tetsuji Yokoyama 《World Journal of Gastroenterology》 SCIE CAS 2017年第39期7150-7159,共10页
AIM To determine whether the presence of columnar-lined esophagus(CLE) is associated with the presence of esophageal varices(EVs) in male Japanese alcoholics. METHODS The subjects were 1614 Japanese alcohol-dependent ... AIM To determine whether the presence of columnar-lined esophagus(CLE) is associated with the presence of esophageal varices(EVs) in male Japanese alcoholics. METHODS The subjects were 1614 Japanese alcohol-dependent men(≥ 40 years of age) who had undergone upper gastrointestinal endoscopic screening. Digitalized records of high-quality endoscopic images that included the squamocolumnar junction and esophagogastric junction were retrospectively jointly reviewed by four expert endoscopists for the purpose of diagnosing CLE. The authors investigated whether and to what extent there were associations between the presence of CLE and the presence of EVs, especially in the group with liver cirrhosis(LC).RESULTS CLE ≥ 5 mm in length was found in 355 subjects(≥ 30 mm in 6 of them), LC without EVs in 152 subjects, LC with EVs in 174 subjects, and EVs without LC in 6 subjects. Advanced EVs, i.e., nodular, large or coiled forms, red color sign, or post-treatment, were found in 88 subjects. The incidence of CLE ≥ 5 mm decreased in the following order(P < 0.0001): 23.3% in the group without EVs, 17.4% in the group with small and straight EVs, and 5.7% in the group with advanced EVs. The multivariate ORs(95%CI) for EVs and advanced EVs in the group with LC were lower when CLE ≥ 5 mm was present [0.46(0.23-0.93) and 0.24(0.08-0.74), respectively, vs 0-4 mm CLE]. CONCLUSION The presence of CLE in male Japanese alcoholics was negatively associated with the presence of EVs. 展开更多
关键词 ALCOHOL Columnar-lined esophagus Hiatal hernia Liver cirrhosis Portal hypertension Esophageal varices
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