垂体后叶素对肝硬化患者门脉血流动力学的影响及与肝功能分级的关系  

Effects of Vasopression on Portal Hemodynamics and Relations between The Effects and Child Pugh Classification in Patients with Hepatic Cirrhosis

作　　者：许洪伟[1] 杨美兰[1] 秦成勇[1] 万昭海[1] 

机构地区：[1]山东省立医院

出　　处：《山东医药》1999年第15期5-6,共2页Shandong Medical Journal

摘　　要：应用彩色多普勒血流显像（ＣＤＦＩ）引导下的脉冲多普勒（ＰＤ）超声技术，评估垂体后叶素（ＶＰ）对４１例肝硬化患者门脉系统血流动力学的影响及其与Ｃｈｉｌｄ－Ｐｕｇｈ法肝功能分级的关系。结果显示，ＶＰ以０．３Ｕ／ｍｉｎ的剂量持续静滴时，可使门脉流速、流量分别降低３９．４％、４０．１％；使Ｃｈｉｌｄ－ＰｕｇｈＡ、Ｂ、Ｃ三级肝硬化门脉血流量分别降低４１．１％、３８．２％、４１．４％，三者比较无显著差异（Ｐ＞０．０５）。认为ＶＰ可通过降低门脉血流量而降低门脉高压。ＶＰ对Ａ、Ｂ、Ｃ三级肝硬化门脉高压症患者的门脉血流效应相似，临床观察ＶＰ治疗Ｃ级肝硬化食管静脉曲张破裂出血（ＥＶＢ）较Ａ、Ｂ级成功率低并非门脉血流动力学对ＶＰ敏感性有差异。建议临床控制肝硬化食管胃底静脉曲张破裂出血不宜盲目加大ＶＰ用量。With pulsed Doppler(PD)ultrasonography guided by color doppler flow imaging(CDFI),effects of vasopressin(VP)on portal hemodynamics and relations between the effects and Child pugh classification were evaluated in 41 patients with hepatic cirrhosis The results showed that after administration of VP by intravenous infusion at a rate of 0 3u/min,the portal venous velocity and flow were significantly decreased by 39 4% and 40 1% respectively(P<0 001),the portal venous flow(Q)of grade A、B、C were significantly decreased by 41 1%、38 2%and 41 4% respectively(P<0 001),and the levels of reduction were not significantly different (P>0 05) The results indicated that VP reduced portal venous pressure by means of reducing Q;the effects of VP on the portal hemodynamics in cirrhotic patients with grade A、B、C were similar;the difference of curative effects of VP on acute esophageal variceal bleeding(EVB)in cirrhotic patients with grade A、B、C was not due to difference of portal hemodynamic response to VP These suggested that the dose of VP in the treatment of EVB should not be increased blindly

关 键 词：垂体后叶素 肝硬化 门脉血流动力学 肝功能 

分 类 号：R575.202[医药卫生—消化系统]