CAJ | 학술논문

目的观察门静脉和下腔静脉阻断与开放后门静脉高压模型犬体循环的变化及与NO/ET、PGI2/TXA2的关系.方法正常家犬12只,随机均分为对照组和门静脉高压模型组(采用部分结扎门静脉的方法建立门静脉高压症犬的模型并饲养12周),进行门静脉和肝后下腔静脉阻断与开放实验,监测围术期心率(HR)、平均动脉压(MABP)、中心静脉压(CVP)、肺动脉楔压(PAWP)、心指数(CI)、体循环阻力指数(SVRI).分别于麻醉后术前、无肝期30min、新肝期30min 3个时点抽取中心静脉血,用放免法测定血浆一氧化氮(NO)/内皮素(ET)、前列环素(PGI_2)/血栓素A2(TXA_2)水平.结果在门静脉和下腔静脉阻断后两组犬出现了明显的体循环的变化,表现为门静脉和下腔静脉阻断后均处于低有效循环,但模型组相对稳定;门静脉高压模型组围术期体循环血浆NO水平在门静脉和下腔静脉阻断后持续显著降低.结论在围术期两组犬出现了明显的体循环的变化,门静脉高压组阻断期体循环相对稳定,血浆NO、ET、PGI_2、TXA_2的意义需进一步探讨.
목적 관찰문정맥화하강정맥조단여개방후문정맥고압모형견체순배적변화급여NO/ET、PGI2/TXA2적관계.방법 정상가견12지,수궤균분위대조조화문정맥고압모형조(채용부분결찰문정맥적방법건립문정맥고압증견적모형병사양12주),진행문정맥화간후하강정맥조단여개방실험,감측위술기심솔(HR)、평균동맥압(MABP)、중심정맥압(CVP)、폐동맥설압(PAWP)、심지수(CI)、체순배조력지수(SVRI).분별우마취후술전、무간기30min、신간기30min 3개시점추취중심정맥혈,용방면법측정혈장일양화담(NO)/내피소(ET)、전렬배소(PGI_2)/혈전소A2(TXA_2)수평.결과 재문정맥화하강정맥조단후량조견출현료명현적체순배적변화,표현위문정맥화하강정맥조단후균처우저유효순배,단모형조상대은정;문정맥고압모형조위술기체순배혈장NO수평재문정맥화하강정맥조단후지속현저강저.결론 재위술기량조견출현료명현적체순배적변화,문정맥고압조조단기체순배상대은정,혈장NO、ET、PGI_2、TXA_2적의의수진일보탐토.
Objective To observe the changes in systemic hemodynamics and their relations to the concentrations of nitric oxide,endothelin,prostacyclin,and thromboxane A2 after portal cavity clamping and opening in portal hypertensive canines.Methods Twelve canines were randomly divided into control group and model group,and partial ligation of the portal vein was performed in the model group.Portal cavity clamping and opening WaS performed 12 weeks later in the two groups.The hemodynamic parameters including cardiac output index(CI),heart rate(HR),mean artery blood pressure(MABP),central venous pressure(CVP),pulmonary arteriole wedge pressure(PAWP),and systemic vascular resistance index(SVRI) were measured during the operation.Samples were obtained from the central vein at 3 time points during the operation for measuring NO,ET,PGI2,and TXA2.Results Portal vein ligation and portal cavity clamping produced obvious changes in the systemic circulation of the dogs,and the alteration was milder in the control group.After obstruction of the portal vein,the NO levels in systemic circulation in portal hypertensive dogs declined obviously,but gradually recovered the normal level after reperfusion.Conclusion Systemic circulation undergoes significant alterations after portal vein obstruction,but its changes in portal hypertensive dogs are milder than those in the control group,the mechanism of which needs further investigation.