血吸虫病性门静脉高压症兔肝脏微血管构筑变化的研究

目的:探讨血吸虫病门静脉高压症时肝脏微血管构筑的变化及其可能在全身高动力循环状态中的作用。方法:采用腹部敷贴法感染血吸虫尾蚴建立血吸虫病性肝纤维化模型,经插管检测心输出量(CO)、平均动脉压(MAP)、心率(HR)和肝静脉嵌塞压(WHVP),按公式计算心脏指数(CI)、外周血管阻力(SVR);通过血管铸型方法观察肝脏微血管构筑。结果:与正常兔比较,血吸虫病兔CO、CI明显增高,MAP和SVR显著降低,WHVP升高,两组间HR差异无统计学意义。肝脏微血管铸型观察,血吸虫病时肝内微血管形态和比例严重失常,肝窦显著膨大,门静脉主干增粗,肝内形成广泛的小吻合支,其间以门静脉终末支与肝静脉终末支、门静脉小分支直接引流入肝静脉多见。结论:血吸虫病性门静脉高压症兔存在肝内门-体分流病理改变,可能是形成全身高动力循环状态并维持门静脉高压的一个重要环节。

Architectural Changes of Intrahepatic Microangium in Schistosoma-Infected Rabbits with Portal Hypertension

Objective: To explore architectural changes of intrahepatic microangium in schistosoma-infected rabbits and its role on systemic hyperdynamic circulation.Method: The liver fibrosis model was established by abdominal application with schistosoma cercarie.The cardiac output(CO)、cardiac index(CI)、mean arterial pressure(MAP)、heart rate(HR)、peripheral vascular resistance(SVR) and wedged hepatic-vein pressure (WHVP) were measured by physiograph;vascular casts of intrahepatic microangium were observed by scanning electron microscopy.Results: Compared with the control group, the CO、CI and WHVP increased significantly(P<0.05) and the MAP、SVR decreased significantly(P<0.05) in the model group. Scanning electron microscopy showed wide intrahepatic collateral microangium,which was commonly observed between portal veins,hepatic veins and branch of portal veins linking up hepatic veins,emerging in schistosoma-infected rabbits with portal hypertension.Conclusion: Intrahepatic portal-systemic shunts exist in schistosoma-infected rabbits with portal hypertension,which was a major possible reason of the development of systemic hyperdynamic circulation and maintenance of portal hypertension.