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目的:比较经门静脉和股静脉注入扩血管药物后对肝硬化大鼠门脉血流动力学紊乱的差异,从而寻找更合适的途径降低门脉压力,改善肝脏血流.方法:采用酒精联合CCl4法建立肝硬化门脉高压大鼠模型,42只大鼠随机化平均分成6组,分别为硝酸甘油门脉组和硝酸甘油股静脉组(NG门和NG股)、前列腺素E1门脉组和前列腺素E1股静脉组(PGE1门和PGE1股)、生理盐水门脉组和生理盐水股静脉组(NaCl门和NaCl股).使用超声多普勒测定给药前后不同时间段门静脉内径(PVD)、门静脉血流速度(PFR)和肝门静脉血流量(PVF)的变化情况.结果:NaCl门组和NaCl股组给药前后PVD、PFR、PVF均无显著性差异(P=0.1742,P=0.2372,P=0.6566),而NG门、NG股和PGE1门、PGE1股4组给药后PVD均明显扩张,但不同给药方式和不同药物之间无显著差异(P=0.0516,P=0.1225);给药后PVF增加,NG股和PGE1股组增加量明显大于NG门和PGE1门组,且差异具有显著性(P<0.0001);较给药前,给药后10、20minNG股和PGE1股组PFR明显增加,而NG门和PGE1门组却显著减少,差异具有显著性[NG股:4.98mm/(s*100g)±0.62mm/(s*100g),4.31mm/(s*100g)±0.46mm/(s*100g)vs3.62mm/(s*100g)±0.38mm/(s*100g);PGE1股:3.96mm/(s*100g)±0.56mm/(s*100g),4.18mm/(s*100g)±0.50mm/(s*100g)vs3.63mm/(s*100g)±0.47mm/(s*100g),P<0.0001;NG门:2.93mm/(s*100g)±0.22mm/(s*100g),3.13mm/(s*100g)±0.21mm/(s*100g)vs3.70mm/(s*100g)±0.48mm/(s*100g);PGE1门:3.65mmmm/(s*100g)±0.22mm/(s*100g),3.36mm/(s*100g)±0.21mm/(s*100g)vs3.84mm/(s*100g)±0.19mm/(s*100g),P<0.001].结论:硝酸甘油和前列腺素E1可以明显增加经门静脉入肝血流量,但门静脉直接注药方式并不优于股静脉注药方式.
OBJECTIVE: To compare the differences of portal hemodynamic disorders in cirrhotic rats after vasodilator injected through the portal vein and femoral vein in order to find a more appropriate way to reduce portal pressure and improve hepatic blood flow.Methods: Alcohol and CCl4 Method to establish cirrhotic rat model of portal hypertension, 42 rats were randomly divided into six groups, namely nitroglycerin portal vein group and nitroglycerin femoral vein group (NG and NG), prostaglandin E1 portal vein group and (PGE1 and PGE1), normal saline portal vein and normal saline femoral vein (NaCl and NaCl) were used to measure the portal vein diameter (PVD) at different time points before and after the administration of Doppler, (PFR) and portal vein blood flow (PVF) were measured.Results There were no significant differences in PVD, PFR and PVF before and after treatment between NaCl and NaCl groups (P = 0.1742, P = 0.2372 , P = 0.6566). However, PVD, NG, NG, PGE1, and PGE1 were significantly expanded in all four groups (P = 0.0516, P = 0.1225) ; PVF increased after administration, NG and PGE1 shares increased significantly larger than the NG gate and PGE1 gate group, and the difference with (P <0.0001). Before treatment, the PFR of NG and PGE1 groups were significantly increased at 10,20 and 20min after administration, while the levels of NG and PGE1 were significantly decreased, the difference was significant [NG: 4.98mm / (s * 100g) ± 0.62mm / (s * 100g) ± 0.38mm / (s * 100g) ± 0.46mm / (S * 100 g) ± 0.50 mm / (s * 100 g) vs 3.63 mm / (s * 100 g) ± 0.47 (s * 100g) ± 0.21mm / (s * 100g), P <0.0001; NG door: 2.93mm / (s * 100g) ± 0.22mm / (s * 100g), 3.36mm / (s * 100g) ± 0.21mm / (s * 100g) ± 0.48mm / (s * 100g) vs3.84mm / (s * 100g) ± 0.19mm / (s * 100g), P <0.001] .Conclusion: Nitroglycerin and prostaglandin E1 can significantly increase the blood flow through the portal vein, Portal vein injection method is not superior to femoral vein injection method.