缬沙坦对肝硬化门脉高压作用及机制研究  

Effects of Valsartan on portal hemodynamics in cirrhosis and its mechanism

作　　者：申振宇[1] 蒋晓峰[2] 马方[1] 吴家康[1] 陶春华[1] 郭传勇[1] 

机构地区：[1]同济大学附属第十人民医院消化内科,上海200072 [2]同济大学附属同济医院肾内科,上海200065

出　　处：《同济大学学报（医学版）》2008年第2期46-48,共3页Journal of Tongji University(Medical Science)

摘　　要：目的研究缬沙坦对肝硬化门脉血流动力学的影响并探讨其作用机制。方法肝硬化患者观察组和对照组各24例,分别给予口服缬沙坦80 mg/d的一周和常规治疗。用药前后应用彩色多普勒超声仪检测门静脉和脾静脉内径并计算其平均流速和血流量。同时放免法测定血浆肾素活性和血管紧张素Ⅱ。结果服用缬沙坦后门静脉和脾静脉内径缩小,与用药前相比P<0.05;它们的平均流速和血流量均有降低,与用药前相比P<0.05。用药后血浆肾素活性和血管紧张素Ⅱ较用药前则明显升高(P<0.05)。结论缬沙坦可以使肝硬化患者门脉压力降低,可能与调控肾素血管紧张素醛固酮系统有关。Objective To assess the effects of Valsartan on portal hemodynamics in cirrhosis and its mecha- nism. Methods Forty-eight patients with hepatic cirrhosis were divided into observation group and control group. Twenty-four patients in observation group received Valsartan （Diovan） 80 mg/day for 7 days and twenty-four patients in control group received routine treatment. Diameter of portal or splenic vein and their mean velocity or flow volume were measured before and after treatment by sonographic examinations. Plasma renin activity and concentration of plasma angiotensin Ⅱ were simultaneously assessed by radioimmunoassay. Results Valsartan not only reduced the diameter but also the mean velocity and blood flow of portal or splenic vein （ P 〈 0.01 ）. Valsartan also increased plasma renin activity and concentration of plasma angiotensin Ⅱ （P 〈 0.01 ）. Conclusion Valsartan decreases the portal pressure in cirrhotic patients. The regulation of the renin-angiotensin-aldosterone system may be involved in the mechanism.

关 键 词：缬沙坦 肝硬化 门脉压力 血管紧张素 

分 类 号：R571[医药卫生—消化系统]