门静脉高压症患者血儿茶酚胺浓度及其拮抗剂的作用  

Serum catecholamine levels and effect of phentolamine administration on pertal hemodynamics in cirrhotic patients with potral hypertension

作　　者：朱继业[1] 陈雷[1] 冷希圣[1] 杜如昱[1] 

机构地区：[1]北京医科大学人民医院普外科

出　　处：《普外临床》1997年第1期48-50,共3页

基　　金：国家自然科学基金

摘　　要：为了解儿茶酚胺类递质在肝硬变门静脉高压症发病中的作用，作者测定了１３例经病理证实的坏死后肝硬变门静脉高压症患者及３４例无肝脏和心血管疾病的对照者周围静脉血中的肾上腺素及去甲肾上腺素的浓度，并观察了从周围静脉输入α肾上腺素受体拮抗剂酚妥拉明前后肝硬变门静脉高压症患者肝静脉楔入压、自由肝静脉压和肝静脉压力梯度的变化。结果显示肝硬变组周围血肾上腺素和去甲肾上腺素浓度分别为５３．４±２３．９ｐｇ／ｍｌ，４４６．０±３１０．７ｐｇ／ｍｌ，显著高于对照组２３．５±１１．２ｐｇ／ｍｌ，１８３±８３．３ｐｇ／ｍｌ，（Ｐ＜０．０１）。持续静点酚妥拉明后肝静脉楔入压及肝静脉压力梯度显著下降（肝静脉楔入压下降０．５５～０．６３ｋＰａ，Ｐ＜０．０１；肝静脉压力梯度下降０．６２ｋＰａ，Ｐ＜０．０１）。本研究结果表明：肝硬变门静脉高压患者存在着明显的儿茶酚胺类递质代谢紊乱，其对内脏血流动力学的影响与门静脉高压症的发生、发展有密切关系；α－肾上腺素受体拮抗剂酚妥拉明能有效地降低门静脉压力。Abstract: To investigate the effect of catecholamine on the pathogenesis of portal hypertension, high pressure liquid chromatography was used to measure peripheral serum adrenaline (E) and noradrenaline(NE) concentrations in 13 patients with postnecrotic cirrhosis proved by pathology and 34 control patients without hepatopathy and cardiovascular diseases. Changs in Wedged Hepatic Venous Pressure(WHVP),Free Hepatic Venous Pressure(FHVP)and Hepatic Venous Pressure Gradient(HVPG) in portal hypertensive patients were observed and after the infusion of α-andrenoceptor antagonist phentolamin byperipheral vein. Peripheral E and NE levels in cirrhotic patients were 53. 4±23. gpg／ml and 446. 0±310. 7pg／ml, respectively, which were significantly higher than 23.5±11.2pg/ ml and 183± 83. 3pg／ml, respectively in controls(P＜0.01). WHVP and HVPG decreased significantly (WHVP 0.55~0. 63KPa, P＜0.01; HVPG 0.62kPa,P ＜0.01) after the infusion of phentolamin. our results reveal significant metabolic disorders of E and NE in portal hypertensive patients, which may play a important role in the pathogenesis of portal hypertension. Alpha-andrenergic antagonist pentolamine effects a significant decrease in portal pressure.

关 键 词：门静脉高血压 儿茶酚胺 拮抗剂 

分 类 号：R657.340.2[医药卫生—外科学]