卡维地洛与普萘洛尔降低肝硬化门静脉高压效果的对照研究  

The randomized controlled study of the efficacy of carvedilol and propranolol in patients with cirrhosis and portal hypertension

作　　者：李波[1] 黄志刚[1] 沈健伟[1] 宋毓飞[1] 

机构地区：[1]宁波市医疗中心李惠利医院消化科,315041

出　　处：《浙江医学》2012年第24期1973-1975,共3页Zhejiang Medical Journal

摘　　要：目的探讨卡维地洛与普萘洛尔降低肝硬化门静脉高压患者肝静脉压力梯度（HVPG）的疗效。方法将72例肝硬化合并门静脉高压患者随机分为卡维地洛组、普萘洛尔组及安慰剂组，每组24例，分别服用卡维地洛、普萘洛尔及安慰剂，对比服药前及服药1个月后的血流动力学指标。结果卡维地洛及普萘洛尔均能显著降低肝硬化合并门静脉高压患者的HVPG（均P〈0．05），且卡维地洛降低HVPG及平均动脉压的幅度大于普萘洛尔（均P〈005）。卡维地洛组HVPG降至基线值20％以下或12mmHg以下患者比例亦明显多于普萘洛尔组（P〈0．05）。而普萘洛尔降低心率及心排出量的幅度均大于卡维地洛（均P〈0．05）。结论卡维地洛在降低肝硬化门静脉高压患者的门静脉压力方面较普萘洛尔更具优势。Objective To investigate the efficacy of carvedilol and propranolol to reduce the portal hypertension or hepatic venous pressure gradient （HVPG）. Methods Seventy-two cirrhotic patients had hemodynaimic measurements before and a month after randomized into carvedilol group （n=24）, propranolol group （n=24）,or placebo group （n=24）. Results HVPG in carvedilol and propranolol group both decreased remarkably, while there was a significantly greater decrease in HVPG and mean arterial pressure in carvedilol group （P〈0.05）. Moreover, carvedilol decreased HVPG greater than 20% of baseline values or to ≤ 12mmHg in a greater proportion of patients（P〈0.05） than propranolol, and the reduction in heart rate and cardiac output was more minor（P〈0.05）. Conclusion Carvedilol may have the advantage in reduction of portal hypotensive in patients with cirrhosis.

关 键 词：卡维地洛 普萘洛尔 肝硬化 门静脉高压 肝静脉压力梯度 

分 类 号：R657.34[医药卫生—外科学]