RESUMO
Serum concentrations of ANF, Renin and Aldosterone were measured in animals with experimental cirrhosis and volume overload. We studied 75 Wistar rats divided in five groups. Group I: rats with hepatic cirrhosis induced by CCl4; Group II: Control rats; Group III: rats with hepatic cirrhosis and continuous infusion of saline serum; Group IV: control rats with continuous infusion and Group V: cirrhotic rats and bolus infusion of saline. There were no statistical differences in serum concentrations of ANF (232 +/- 75 vs 195 +/- 42 pg/ml) and Renin concentration (182 +/- 24 vs 171 +/- 34 ng/ml/hour) between controls and rats with cirrhosis. However, Aldosterone levels were elevated in cirrhotic rats in basal conditions as compared to controls (1197 +/- 287 vs 475 +/- 88 pg/ml; p < 0.001). The volume overload caused a paradoxical decrease of ANF in cirrhotic rats (124 +/- 15 and 122 +/- 17; p < 0.001). On the other hand, no changes were observed in Renin and Aldosterone after volume expansion. These results suggest the existence of a hemodynamic response to compensate the volume overload. Other studies are necessary to confirm this hypothesis.
Assuntos
Aldosterona/sangue , Fator Natriurético Atrial/sangue , Volume Sanguíneo , Cirrose Hepática Experimental/sangue , Cirrose Hepática Experimental/fisiopatologia , Renina/sangue , Animais , Masculino , Ratos , Ratos WistarRESUMO
Tissue plasminogen activator (t-PA) activity was studied in three different experimental models of male Wistar rats; hepatic lesion without portal hypertension, portal hypertension without hepatic lesion and portal hypertension plus function liver suppression by ligation of both portal vein and hepatic artery. t-PA activity was higher in animals with portal hypertension alone than in animals with only hepatic lesion (146%). Maximal values were present in animals with functional liver suppression (1.774% vs. controls, 248% vs. hepatic lesion and 169% vs. portal hypertension only). These results suggest that both reduced hepatic t-PA clearance and portal hypertension could be involved in the increased t-PA activity normally appearing in chronic liver disease.
Assuntos
Hipertensão Portal/metabolismo , Hepatopatias/metabolismo , Ativador de Plasminogênio Tecidual/metabolismo , Animais , Hipertensão Portal/etiologia , Hepatopatias/complicações , Masculino , Ratos , Ratos WistarRESUMO
TIPSS is a new therapeutic modality for decompressing the portal tree and its use has broadened in the last five years. From February 1993 to August 1994 a prospective study was performed to evaluate its efficacy and safety. Nineteen cirrhotic patients (Child A-5, B-10, and C-4) with a TIPSS placed were included. The mean follow-up was 7.2 months. The indication was therapy of esophageal variceal bleeding in 18 patients (acutely in 8 and elective in 10 patients) and refractory ascites in one. In all cases could the "stent" be placed and the portocaval gradient decreased from 22.8 +/- 3.71 to 9.3 +/- 2.27 mmHg. In the first thirty days the mortality rate was 10.5%, with the following complications: two portal thromboses, two acute non-lithiasic cholecystitis, one hemoperitoneum, one spontaneous bacterial peritonitis, and one hepatic encephalopathy. During the follow-up period two patients developed hemorrhagic relapses and two additional patients subclinical encephalopathy. TIPSS dysfunction was observed in 57.8%.