硝苯地平控释片对肝硬化患者门脉血流动力学影响的双功多普勒观察  

Effects of release controlled nifedipine on portal hemodynamics in cirrhotic patients evaluated by duplex Doppler ultrasonography

作　　者：秦成勇[1] 刘东兴[1] 朱菊人[1] 傅丽娜[1] 万昭海[1] 张国全[1] 贾涛[1] 

机构地区：[1]山东省立医院消化科,济南250021

出　　处：《中华消化杂志》2000年第2期111-113,共3页Chinese Journal of Digestion

摘　　要：目的　研究硝苯地平控释片对门脉高压的治疗作用。方法　以双功多普勒技术检测了3 2例肝硬化门脉高压患者在用硝苯地平控释片 3 0mg 1次 /d前后门脉血流动力学的变化。 结果　用药后门静脉流速降低 ,充血指数上升 ;脾静脉流速、流量降低 ;肝动脉、脾动脉的阻力指数及脉动指数降低 ;肝总血流量增加 ;平均动脉压及心率无显著变化。结论　肝、脾动脉的阻力指数及搏动指数是门脉阻力的良好指标。硝苯地平控释片可通过如下机制降低门脉压 :①降低全身血压引起交感神经反射使内脏动脉收缩 ,门脉血流减少 ;②扩张门脉及肝窦 ,降低门脉阻力 ;③扩张侧支循环。该药对血压正常的肝硬化患者的平均动脉压无显著影响 ,有良好的应用前景。Objective To evaluate the therapeutic effect of release controlled nifedipine on portal hypertension. Methods 32 cirrhotic patients were enrolled to investigate the portal hemodynamic changes before and after given Adalat GITS 30 mg qd by duplex doppler ultrasonography. Results After given the therapy, the diameter (D)、blood velocity (V) and blood flow (Q) of portal vein decreased, however, only the change of V had statistical significance. The congestion index (CI) increased; the V and Q of splenic vein significantly decreased; the resistance index (RI) and pulsation index (PI) of right hepatic artery(RHA) and splenic artery decreased obviously. Total hepatic blood flow was elevated slightly and there were no significant changes in MAP and HR. Conclusions RI and PI of hepatic artery and splenic artrey are good indices of portal resistance, release controlled nifedipine may decrease portal pressure by the following mechanisms: ① decrease of systemic blood pressure triggers the sympathetic reflex, leading to splanchnic artery constriction portal blood flow reduction. ② dilatation of the portal vein and sinusoids to decrease the portal resistance. ③ dilatation of the collateral veins. This drug has no obvious effect on the systemic circulation in normotensive cirrhotic patients, hence, it has a good prospect for clinical use in portal hypertension.

关 键 词：肝硬化 药物疗法 硝苯地平控释片 血流动力学 

分 类 号：R575.2[医药卫生—消化系统]