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目的 研究肝硬变时血浆、胃粘膜组织中血管紧张素Ⅱ（Angiotensin Ⅱ,Aug Ⅱ）的水平与胃粘膜微血管形态学变化、胃粘膜血流（Gastric mucosal blood flow,GMBF）、胃粘膜病变（Gastric mucosaldamage,GMD）之间的关系。方法 用四氯化碳皮下注射并饮用乙醇水制备的Wistar大鼠肝硬变模型为实验组,该组又分两个亚组,即肝硬变中期组（纤维增生期）和晚期组（肝硬变形成期）。对照组为用橄榄油并饮用自来水制备的动物模型。观察不同病期血浆、胃粘膜中Ang Ⅱ与胃粘膜微血管形态学变化、胃粘膜血流、胃粘膜损伤程度的关系,以及应用血管紧张素转换酶抑制剂（Angiotensin-converting enzyme in-hibitor,ACEI）Enalaprili后对胃粘膜微血管形态学变化、胃粘膜血流、胃粘膜损伤程度的影响。结果 肝硬变各组大鼠血浆、胃粘膜Ang Ⅱ水平明显高于相应对照组（P<0.01,P<0.01）而胃粘膜微血管密度、胃粘膜血流明显低于相应对照组;胃粘膜损伤程度明显高于对照组。Enlaprili（5mg/kg体重,术前连续7d,每天一次）灌胃后,胃粘膜微血管密度明显升高,胃粘膜血流下降明显减少（P<0.01）,胃粘膜损伤程度降低（P<0.01）。结论 在肝硬变胃粘膜病变中内源性Ang Ⅱ具有重要作用,ACEI-Enalaprili对肝硬变胃粘膜具有一定的保护作用。
Objective To study the relationship between the levels of angiotensin Ⅱ (Ang Ⅱ) and the changes of microvascular morphology in gastric mucosa, gastric mucosal blood flow (GMBF) and gastric mucosal lesions ( Gastric mucosaldamage, GMD). Methods Wistar rat model of liver cirrhosis prepared by subcutaneous injection of carbon tetrachloride and drinking ethanol was used as the experimental group. The experimental group was subdivided into two subgroups: the mid-cirrhosis group (fibrotic stage) and the late stage group (liver fibrosis stage) Hard to mature). The control group was an animal model prepared with olive oil and tap water. To investigate the relationship between angiotensin Ⅱ (Ang Ⅱ) and microvascular morphology of gastric mucosa, gastric mucosal blood flow and gastric mucosal lesion in plasma and gastric mucosa at different stages, as well as the relationship between angiotensin-converting enzyme in-hibitor (ACEI) ) Enalaprili on gastric mucosal microvascular morphological changes, gastric mucosal blood flow, gastric mucosal injury. Results The level of Ang Ⅱ in plasma and gastric mucosa in rats with liver cirrhosis was significantly higher than that in the corresponding control group (P <0.01, P <0.01), while the microvessel density in gastric mucosa and gastric mucosal blood flow were significantly lower than those in the corresponding control group. The degree was significantly higher than the control group. Gastric mucosa microvessel density was significantly increased, gastric mucosal blood flow decreased significantly (P <0.01) and gastric mucosal lesion was lessened (P <0.01) after intragastric administration of Enlaprili (5mg / kg body weight, preoperatively for 7d, once daily) . Conclusions Endogenous Ang Ⅱ plays an important role in the pathogenesis of gastric mucosal lesions of liver cirrhosis. ACEI-Enalaprili has a protective effect on gastric mucosa of cirrhosis.