卡维地洛与普萘洛尔治疗肝硬化合并食管胃底静脉曲张患者的临床研究  

Clinical trial of carvedilol and propranolol in the treatment of patients with liver cirrhosis and esophageal and gastric varices

作　　者：田毅萍[1] 蔡瑞君[1] 王维 TIAN Yi-ping;CAI Rui-jun;WANG Wei(Department of Pharmacy,Jiuquan People's Hospital,Jiuquan 735000,Gansu Province,China;Department of Gastroenterology,Jiuquan People's Hospital,Jiuquan 735000,Gansu Province,China)

机构地区：[1]酒泉市人民医院药剂科,甘肃酒泉735000 [2]酒泉市人民医院消化内科,甘肃酒泉735000

出　　处：《中国临床药理学杂志》2020年第18期2759-2761,共3页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察卡维地洛与普萘洛尔对肝硬化合并食管胃底静脉曲张患者肝静脉压力梯度(HVPG)、一氧化氮(NO)水平的影响及安全性。方法将110例肝硬化合并食管胃底静脉曲张患者,随机分为对照组(55例)和试验组(55例)。对照组给予普萘洛尔,每次20 mg,每天2次,口服。试验组给予卡维地洛,初始剂量为每天6.25 mg,剂量逐渐增加不超过每天12.5 mg,均为每天2次。2组均连续治疗2个月。比较2组患者的血流动力学、NO及安全性。结果治疗后,试验组和对照组的HVPG分别为(9.72±1.10),(13.03±1.25)mmHg,肝静脉契压(WHVP)分别为(16.28±2.84),(19.82±2.71)mmHg,平均动脉压(MAP)分别为(86.25±9.51),(90.26±11.27)mmHg,血清NO分别水平为(74.82±10.08),(86.94±11.10)μmol·L^-1,差异均有统计学意义(均P<0.05)。试验组药物不良反应发生率为9.09%,与对照组的3.64%比较,差异无统计学意义(P>0.05)。结论卡维地洛与普萘洛尔均可在一定程度上改善肝硬化合并食管胃底静脉曲张患者的HVPG、WHVP、MAP、NO水平,安全性高,但前者效果更好,且两种药物对肝功能、肾功能无影响。Objective To investigate the effect and safety of carvedilol and propranolol on hepatic vein pressure gradient(HVPG)and nitric oxide(NO)levels in patients with liver cirrhosis complicated with esophageal and gastric varices.Methods A totaol of 110 patients with liver cirrhosis complicated with gastroesophageal varices were randomly divided into control group(55 cases)and treatment group(55 cases).Control group was treated with propranolol,20 mg a time,twice a day,orally.Treatment group was treated with carvedilol,the initial dose was 6.25 mg per day,and the dose gradually increased to no more than 12.5 mg per day,twice per day.Both groups were treated continuously for 2 months.Hemodynamics,NO,liver function,kidney function and safety of the two groups were observed.Results After treatment,the HVPG in treatment group and control gorup were(9.72±1.10),(13.03±1.25)mmHg,wedged hepatic venous pressure(WHVP)were(16.28±2.84),(19.82±2.71)mmHg,mean arterial pressure(MAP)were(86.25±9.51),(90.26±11.27)mmHg,serum NO were(74.82±10.08),(86.94±11.10)μmol·L^-1,all with significant difference(all P<0.05).The incidence of adverse drug reactions in treatment group was 9.09%,and there was no significant difference compared with 3.64%in control group(P>0.05).Conclusion Carvedilol and propranolol can improve the levels of HVPG,WHVP,MAP and NO in patients with liver cirrhosis complicated with esophageal and gastric varices to a certain extent,with high safety,but the former is more effective and the two drugs have no effect on liver function and kidney function.

关 键 词：卡维地洛 普萘洛尔 肝硬化合并食管胃底静脉曲张 肝静脉压力梯度 一氧化氮 

分 类 号：R97[医药卫生—药品]