生长抑素对门静脉高压症患者门静脉血流动力学的影响  

Effect of somatostatin on portal hemodynamics of the patients with portal hypertension

作　　者：杨建芬[1] 吴性江[1] 曹建民[1] 韩建明[1] 黎介寿[1] 

机构地区：[1]南京军区南京总医院普通外科研究所,210002

出　　处：《中华实验外科杂志》2004年第7期869-870,共2页Chinese Journal of Experimental Surgery

摘　　要：目的研究生长抑素对门脉高压症患者门静脉血流动力学的影响和外周静脉血中胰岛素样生长因子(IGF1)、血管内皮素(ET1)、胰高血糖素(GLU)、一氧化氮(NO)浓度变化。方法通过对14例门脉高压症经颈内静脉肝内门体分流术(TIPS)术后患者经颈内静脉留置于门静脉内支架下方的导管,以美国REDMOND,WA太空检测仪直接测压,动态观察门静脉血流动力学改变,同时抽血检测IGF1、NO、ET1、GLU浓度。施他宁(6mg/24h)于TIPS术后24h采用微量泵持续24h经周围静脉输入。分别对患者用药前、用药后8、24h进行检测,结果行交叉自身对照。结果施他宁用药前后门静脉压力最大差值为(9.4±1.0)cmH2O(1cmH2O=0.098kPa),两者差异有非常显著性(P<0.01)。NO、ET1用药前后比较差异无显著性(P>0.05)。IGF1、GLU用药前后比较差异有显著性(P<0.05)。结论生长抑素施他宁(6mg/24h)能显著降低门静脉压力和血中GLU、IGF1水平。其降低门静脉压力的作用机制可能是通过降低GLU、IGF1等激素的分泌和释放,降低肝脏的代谢,减少肝脏的血流量,从而降低门静脉压力。Objectives To study the effects of somatostatin on the portal hemodynamics of the patients with portal hypertension and changes in peripheral blood levels of IGF 1,NO,ET 1 and GLU.Methods The portal pressure was measured directly by means of the intravenous catheter which was placed in the portal vein in 14 patients with portal hypertension after TIPS to investigate the change of portal pressure and the blood levels of IGF 1,NO,ET 1 and GLU were determined before infusion and 8,24 h after each infusion of somatostatin.Results The average decreased value of portal pressure was (9.4± 1.0) cm H 2O after the intravenous infusion of somatostatin.There was a significant reduction in GLU and IGF 1 at 8 and 24 h after somatostatin infusion ( P <0.05),but there was no significant reduction in NO and ET 1 ( P >0.05).Conclusion Somatostatin can reduce portal pressure and the blood levels of GLU and IGF 1 significantly.The machanism of the action might be contributed to the inhibition of the hormone release and secretion such as GLU and IGF 1 and decrease of hepatic metabolism and blood flow leading to a reduction in portal pressure.The metabolic alteration might play an important role in reducing portal pressure.

关 键 词：生长抑素 门静脉高压症 门静脉 血流动力学 一氧化氮 

分 类 号：R657.34[医药卫生—外科学]