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[普萘洛尔用于儿童和青少年门静脉高压症:其剂量及临床、心血管和生化效应]

[Propranolol in children and adolescents with portal hypertension: its dosage and the clinical, cardiovascular and biochemical effects].

作者信息

de Kolster C C, Rapa de Higuera M, Carvajal A, Castro J, Callegari C, Kolster J

机构信息

Departamento de Pediatría, Universidad de Carabobo, Hospital Central de Valencia.

出版信息

G E N. 1992 Jul-Sep;46(3):199-207.

PMID:1340825
Abstract

An adequate propranolol dose to reduce 25% the initial heart rate was searched in 19 children with portal hypertension. 13 were pre-hepatic and 6 hepatic hypertension, mean age: 6.96 +/- 3.48 years, range: 2-14 years. Treatment was started with 0.5 mg/kg/day increasing 0.25 mg/kg/day every third day, needing an average of 26 +/- 13 days (range: 6-54 days) to obtain the response. Daily dose ranged from 1 to 5.25 mg/kg/day (mean: 2.69 +/- 1.16). The highest daily dose was 175 mg, the lowest 23.4 mg (mean: 58.27 +/- 36.6 mg/day). Some parameters were evaluated before and after achieving the dose. There was a significant reduction of mean blood pressure (p < 0.01) and peripheral venous pressure (p < 0.05) in 68.4% of patients. A significant elevation (p < 0.001) of 24 hour urinary catecholamine levels occurred in 94.7%. Side effects were minimal. Propranolol could be considered a safe pharmacological option in these patients.

摘要

在19例门静脉高压患儿中寻找能使初始心率降低25%的合适普萘洛尔剂量。其中13例为肝前性门静脉高压,6例为肝性门静脉高压,平均年龄:6.96±3.48岁,范围:2 - 14岁。治疗从0.5mg/kg/天开始,每三天增加0.25mg/kg/天,平均需要26±13天(范围:6 - 54天)才能获得疗效。每日剂量范围为1至5.25mg/kg/天(平均:2.69±1.16)。最高每日剂量为175mg,最低为23.4mg(平均:58.27±36.6mg/天)。在达到该剂量前后评估了一些参数。68.4%的患者平均血压(p<0.01)和外周静脉压(p<0.05)显著降低。94.7%的患者24小时尿儿茶酚胺水平显著升高(p<0.001)。副作用极小。普萘洛尔可被认为是这些患者的一种安全的药物选择。

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