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目的对肝硬变时血管活性肠肽(vasoactive intestinal peptide,VIP)的肝清除能力进行定量观察。方法采用改良 Miller’s法建立硬变肝脏隔离灌流模型(isolated perfused cirrhotic model,IPCM)行单程灌流(Single-pass perfusion),测定 VIP 的首过肝摄取率及清除率。结果肝硬变时 VIP 肝摄取率(33%±27%)和清除率(8±6ml/min)与正常灌流的肝脏(isolated perfused rat liver,IPRL)无明显差别(P>0.05);但肝脏摄取分数及单位肝重清除率 IPCM(0.06±0.05;0.09±0.25ml·min~(-1)·g~(-1))明显低于 IPRL(0.20±0.13;0.88±0.3ml·min~(-1)·g~(-1))(P<0.01)。结论肝硬变时 VIP 的肝内清除力低于正常肝脏,但肝硬变后肝重和向肝血流量的增加作为一种代偿可部分弥补 VIP 肝清除能力的不足。
Objective To quantitatively observe the hepatic clearance ability of vasoactive intestinal peptide (VIP) in patients with cirrhosis. Methods Single-pass perfusion was performed with isolated perfused cirrhotic model (IPCM) using modified Miller’s method to determine the first-pass hepatic uptake and clearance of VIP. Results There was no significant difference in the hepatic cirrhosis with VIP liver uptake rate (33% ± 27%) and clearance (8 ± 6ml / min) compared with isolated perfused rat liver (IPRL) IPCC (0.06 ± 0.05; 0.09 ± 0.25ml · min -1 · g -1) were significantly lower than IPRL (0.20 ± 0.13; 0.88 ± 0.3ml · min -1 -1) · g -1 (P <0.01). Conclusions The intrahepatic clearance of VIP is lower than that of normal liver in patients with cirrhosis. However, the increase of liver weight and hepatic blood flow after cirrhosis can be partly compensated for the lack of VIP hepatic clearance.