纳多洛尔对肝硬化患者的初级预防:对患者内脏血流动力学的多普勒模式效应比较  

Primary prophylaxis with nadolol in cirrhotic patients:Doppler patterns of splanchnic hemodynamics in good and poor responders

作　　者：Berzigotti A. Rinaldi M.F. Magalotti D. M. Zoli 赵菊辉 

机构地区：[1]Dipartimento di Medicina Interna, Cardioangiologia, Epatologia, Policlinico S. Orsola-Malpighi, Via Albertoni 15, 40138 Bologna, Italy

出　　处：《世界核心医学期刊文摘（胃肠病学分册）》2006年第5期53-53,共1页Core Journals in Gastroenterology

摘　　要：Background/Aims: We aimed to characterize by echo-color-Doppler the splanchnic hemodynamics of patients good and poor responders to primary prophylaxis with nadolol. Methods: Thirty cirrhotic patients (Child-score 7.0± 1.8) with medium/large esophageal varices without previous bleedings were consecutively enrolled. At inclusion and after 3 months of treatment with nadolol, they underwent a splanchnic echo-color-Doppler study and a measurement of hepatic venous pressure gradient (HVPG). Results: Nadolol (60± 36 mg/day; range 20-160) induced a significant reduction of HVPG (16.6± 6.1 vs. 19.4± 4.6 mmHg, P< 0.0001). 13 patients (43.3% ) were hemodynamic responders. Responders and Poor-res-ponders had similar baseline clinical characteristics. Poor-responders at baseline were characterized by lower impedance indexes in superior mesenteric artery (SMA) (PI 2.29± 0.45 vs. 2.74± 0.46; P=0.01; RI 0.83± 0.04 vs. 0.86± 0.03; P=0.02), hepatic artery (HA) (PI 1.41± 0.19 vs. 1.79± 0.48; P=0.03; RI 0.71± 0.05 vs. 0.80± 0.07; P=0.02), and splenic artery (SA) (PI 1.18± 0.27 vs. 1.73± 0.40; P=0.01; RI 0.66± 0.07 vs. 0.73± 0.09; P=0.02), and by higher mean flow velocity of HA (52.6± 21.6 vs. 26.5± 9.5 cm/s; P=0.02) and SMA (49.7± 14.5 vs. 33.9± 13.1 cm/s; P=0.06). Conclusions: Cirrhotic patients poor-responders to nadolol show a pronounced arterial splanchnic vasodilatation at a baseline echo-color-Doppler study. This can be considered a non-invasive clue for the a priori identification of this subgroup of patients.Background/Aims： We aimed to characterize by echo-color-Doppler the splanchnic hemodynamics of patients good and poor responders to primary prophylaxis with nadolol. Methods： Thirty cirrhotic patients （Child-score 7.0 ± 1.8） with medium/large esophageal varices without previous bleedings were consecutively enrolled. At inclusion and after 3 months of treatment with nadolol, they underwent a splanchnic echo-color-Doppler study and a measurement of hepatic venous pressure gradient （HVPG）. Results： Nadolol （60 ± 36 mg/day; range 20 - 160） induced a significant reduction of HVPG （16.6 ± 6. 1 vs. 19.4±4.6 mmHg, P 〈0.0001）. 13 patients （43.3%） were hemodynamic responders. Responders and Poor-responders had similar baseline clinical characteristics.

关 键 词：彩色多普勒超声检查 肝硬化患者 血流动力学 纳多洛尔 内脏血流 初级预防 重度食管静脉曲张 肝静脉压力梯度 动力学改变 超声研究 

分 类 号：R543.16[医药卫生—心血管疾病] R575.2[医药卫生—内科学]