甲氰咪胍对肝硬化门脉高压症犬门脉血液动力学的影响  

Effects of Cimetidine on portal hemodynamics in dogs with cirrhosis and portal hypertension

作　　者：王延龄[1] 陈云波[1] 丁巍[1] 李桂英[1] 王淑敏[1] 李爱景 

机构地区：[1]吉林大学第二医院基本外科,吉林长春130041 [2]长春市精神病医院

出　　处：《吉林大学学报（医学版）》2005年第2期268-271,共4页Journal of Jilin University：Medicine Edition

摘　　要：目的 :探讨甲氰咪胍对肝硬化门脉高压症犬门脉血液动力学的影响。方法 :以胆总管结扎法成功制备胆汁性肝硬化门脉高压症模型犬 11只 ,随机分为两组 ,即甲氰咪胍组 (n=7)和盐水对照组 (n=4 ) ;另取 4只正常犬作正常对照组。经股动脉、股静脉、右颈外静脉分别插管 ,以多导生理记录仪、电磁流量计等检测门脉及全身血液动力学变化 ,使用 RF- 30 0 0型荧光分光光度计测量血浆组织胺浓度。结果 :甲氰咪胍组静脉注射甲氰咪胍 (剂量 0 .0 12 g· kg- 1 ) 5、 15、 30、 6 0、 90和 12 0 min后 ,自由门脉压平均值分别较注射前下降 5 .2 %、 14 .1%、13.7%、 12 .9%、 9.3%和 6 .5 % (P<0 .0 5 ,P<0 .0 1,P<0 .0 1,P<0 .0 1,P<0 .0 1,P<0 .0 5 ) ,肝静脉楔入压、肝静脉压梯度、门静脉阻力均同步下降。肝动脉血流量无显著改变 ,门静脉血流量及全肝血流量轻度增多。肝静脉自由压、下腔静脉压、腹主动脉平均压及心率均无明显变化。自由门静脉压下降最大幅度与股静脉血血浆组织胺浓度呈显著正相关 (r=0 .7874 ,P<0 .0 5 )。盐水对照组及正常对照组上述各指标均无显著变化。结论 :甲氰咪胍通过拮抗肝硬化门脉高压症犬血中异常升高的组织胺的作用 ,舒张肝血管床 ,降低门脉血流阻力 ,从而降低门脉压力 ,同时使门脉及全肝?Objective To investigate the effects of Cimetidine on portal hemodynamics in dogs with cirrhosis and portal hypertension. Methods Cirrhosis and portal hypertension were successfully induced in eleven dogs. These dogs were then divided into Cimetidine group (n=7) and saline control group (n=4),selected other 4 dogs as a normal group. Phisiological polygraph, electromagnetic flowmeters and other devices were used to detect the changes of portal and systemic hemodynamics in the normal group,saline control group, and Cimetidine group after portal hypertensive dogs in Cimetidine group were injected intravenously with Cimetidine (0.012 g·kg~ -1 weight) and portal hypertensive dogs in salme control group with normal saline. Results In Cimetidine group,5,15,30,60,90, and 120 minutes after cimetidine injection, free portal pressure decreased 5.2% (P<0.05),14.1% (P<0.01), 13.7%(P<0.01),12.9%(P<0.01),9.3%(P<0.01),6.5%(P<0.05), respectively. Wedged hepatic venous pressure, hepatic venous pressure gradient, portal venous resistance decreased synchronously. There was no significant change in hepatic arterial flow. Portal venous flow and total hepatic flow slightly increased. There were no significant changes in free hepatic venous pressure, inferior vena cava pressure, mean aorta arterial pressure and heart rate. The maximum decreased value of free portal pressure was significantly positively correlated to the histamine concentrations of femoral vein blood (r=0.787 4, P<0.05). No significant changes of any indexes mentioned above were found in saline control group after injection of normal saline and in normal group. Conclusion Cimetidine can reduce portal pressure, because it can reduce portal venous resistance by antagonizing the action of histamine. Cimetidine can slightly increase portal venous flow and has no bad effects on systemic hemodynamics.

关 键 词：高血压 门静脉 肝硬化 实验性 西咪替丁 血流动力学 

分 类 号：R-332[医药卫生] R657.31