普萘洛尔与5-单硝酸异山梨醇酯联用对肝硬化门静脉血流动力学的影响  

Effects of propranolol plus isosorbide - 5 - mononitrate on portal blood flow in patients with cirrhosis

作　　者：姜慧卿[1] 张晓岚[1] 王燕[1] 姚希贤[1] 

机构地区：[1]河北医科大学第二医院,河北石家庄050000

出　　处：《临床肝胆病杂志》2003年第1期46-47,共2页Journal of Clinical Hepatology

摘　　要：通过彩色多普勒超声显像仪观测普萘洛尔与5-单硝酸异山梨醇酯(ISMN)联用对肝硬化门静脉血流动力学的影响。19例乙型肝炎后肝硬化患者并有内镜证实的食管静脉曲张。治疗组ISMN 20mg,每日2次,普萘洛尔10mg～20mg,每日3次;对照组为健康受试者。采用同个体自身治疗前后对照研究。结果表明应用普萘洛尔与ISMN治疗1周后,Dpv、Vpv均显著性下降(P<0.01),Opv也显著性降低(711.76±515.52 vs 484.02±222.93)mL/min,P<0.01;Qsv显著性降低(558.07±354.62 vs 394.02±267.57)ml/min,P<0.01;但Qsmv的变化不明显(P>0.05)。治疗4周后也获得了同样的效果。普萘洛尔与ISMN联用可以降低Qpv和Qsv,具有预防上消化道出血的作用。To observe the effects of the combination of propranolol with isosorbide - 5 - mononitrate (ISMN) on portal blood flow in cirrhotic patients with Doppler flowmetry. 19 post - hepatitis portal - hypertensive cirrhotic patients received propranolol plus ISMN orally for 4 weeks. Portal blood flow, liver and renal function were assessed at baseline and 4 weeks after treatment. Propranolol plus ISMN caused a marked reduction in portal blood flow, from 711.76 ± 515.52 to 484.02 ± 222.93 ml/min (P<0.0l);the splenic blood flow decreased from 558.07 ± 354.62 to 394.02 ± 267.57 ml/min ( P < 0.01) at the and of the first week. Continued treatment with propranolol plus ISMN reduced the hepatic (431.47 ± 79.28 ml/min, P < 0.01) and splenic blood flow (482.24 ± 264.26 ml/min, P < 0.05) at the and of the fourth week. Propranolol plus ISMN caused a significant decrease in portal blood flow and maybe reduce upper gastroentestinal hemorrhagic rate.

关 键 词：肝硬化 上消化道出血 门静脉 血流动力学 普萘洛尔 5-单硝酸异山梨醇酯 联合治疗 Qpv Qsv 彩色多普勒超声显像仪 

分 类 号：R575.2[医药卫生—消化系统] R573.2[医药卫生—内科学]