Suppr超能文献

普萘洛尔对肝硬化门静脉高压症患者门静脉压力和全身血液动力学的影响:一项前瞻性研究。

Effect of propranolol on portal pressure and systemic hemodynamics in patients with liver cirrhosis and portal hypertension: a prospective study.

机构信息

Department of Internal Medicine and Institute of Lifelong Health, Yonsei University Wonju College of Medicine, Wonju, Korea.

出版信息

Gut Liver. 2007 Dec;1(2):159-64. doi: 10.5009/gnl.2007.1.2.159. Epub 2007 Dec 31.

Abstract

BACKGROUND/AIMS: Propranolol can prevent variceal bleeding by ameliorating portal hypertension. We conducted this study to determine the effect of propranolol on portal hypertension and the optimal required dose in Korean cirrhotic patients.

METHODS

This study prospectively evaluated 50 patients with cirrhosis who exhibited variceal bleeding. The hepatic venous pressure gradient (HVPG), portal venous flow, heart rate (HR), and blood pressure were assessed both at baseline and at 3 months after the treatment. The initial dose of propranolol (20 mg) was subsequently adjusted until the target HR was reached. Patients in whom HVPG reduced by >20% or to less than 12 mmHg were defined as responders.

RESULTS

Propranolol significantly (p<0.01) reduced the HVPG (-21+/-26%, mean+/-standard deviation), portal venous flow (-25+/-21%), HR (-20+/-13%), and blood pressure (-3+/-13%). Twenty-nine patients were responders, and the optimal required dose was 154.4 mg. The main complication was dizziness (24%), but this was not serious enough to require medication withdrawal.

CONCLUSIONS

Propranolol is safe and effective at reducing portal pressure in Korean cirrhotic patients. An effective improvement in portal hypertension requires the dose to be increased until the target HR is reached.

摘要

背景/目的:普萘洛尔可通过改善门脉高压来预防静脉曲张出血。我们进行本研究旨在确定普萘洛尔对韩国肝硬化患者的门脉高压的影响及其最佳所需剂量。

方法

本前瞻性研究评估了 50 例有静脉曲张出血的肝硬化患者。在基线和治疗 3 个月时评估肝静脉压力梯度(HVPG)、门静脉血流、心率(HR)和血压。普萘洛尔的初始剂量(20mg)随后进行调整,直到达到目标 HR。HVPG 降低>20%或降至 12mmHg 以下的患者定义为应答者。

结果

普萘洛尔显著降低 HVPG(-21±/-26%,平均值±标准差)、门静脉血流(-25±/-21%)、HR(-20±/-13%)和血压(-3±/-13%)(p<0.01)。29 例患者为应答者,最佳所需剂量为 154.4mg。主要并发症是头晕(24%),但并不严重,无需停药。

结论

普萘洛尔在韩国肝硬化患者中安全且有效,可降低门脉压。为了有效改善门脉高压,需要增加剂量,直到达到目标 HR。

相似文献

2
Effects of candesartan and propranolol combination therapy versus propranolol monotherapy in reducing portal hypertension.
Clin Mol Hepatol. 2014 Dec;20(4):376-83. doi: 10.3350/cmh.2014.20.4.376. Epub 2014 Dec 24.
6
Prognostic value of acute hemodynamic response to i.v. propranolol in patients with cirrhosis and portal hypertension.
J Hepatol. 2009 Aug;51(2):279-87. doi: 10.1016/j.jhep.2009.04.015. Epub 2009 May 24.

引用本文的文献

1
Update on the Complications and Management of Liver Cirrhosis.
Med Sci (Basel). 2025 Feb 5;13(1):13. doi: 10.3390/medsci13010013.
2
Primary prophylaxis of variceal bleeding in patients with cirrhosis: A comparison of different strategies.
World J Gastrointest Endosc. 2021 Dec 16;13(12):628-637. doi: 10.4253/wjge.v13.i12.628.
5
Changing the cause of liver cirrhosis from hepatitis B virus to fatty liver in Iranian patients.
Gastroenterol Hepatol Bed Bench. 2017 Winter;10(Suppl1):S20-S26.
6
Novelties in the pathophysiology and management of portal hypertension: new treatments on the horizon.
Hepatol Int. 2018 Feb;12(Suppl 1):112-121. doi: 10.1007/s12072-017-9806-1. Epub 2017 Jul 11.
7
β-2 Adrenergic receptor gene polymorphism and response to propranolol in cirrhosis.
World J Gastroenterol. 2015 Jun 21;21(23):7191-6. doi: 10.3748/wjg.v21.i23.7191.
9
Effects of candesartan and propranolol combination therapy versus propranolol monotherapy in reducing portal hypertension.
Clin Mol Hepatol. 2014 Dec;20(4):376-83. doi: 10.3350/cmh.2014.20.4.376. Epub 2014 Dec 24.
10
Is there any vindication for low dose nonselective β-blocker medication in patients with liver cirrhosis?
Clin Mol Hepatol. 2012 Jun;18(2):203-12. doi: 10.3350/cmh.2012.18.2.203. Epub 2012 Jun 26.

本文引用的文献

3
Pharmacological reduction of portal pressure and long-term risk of first variceal bleeding in patients with cirrhosis.
Am J Gastroenterol. 2006 Mar;101(3):506-12. doi: 10.1111/j.1572-0241.2006.00453.x.
4
Endoscopic variceal ligation versus propranolol in prophylaxis of first variceal bleeding in patients with cirrhosis.
J Gastroenterol Hepatol. 2006 Feb;21(2):413-9. doi: 10.1111/j.1440-1746.2005.04071.x.
5
Effects of six months losartan administration on liver fibrosis in chronic hepatitis C patients: a pilot study.
World J Gastroenterol. 2005 Dec 28;11(48):7560-3. doi: 10.3748/wjg.v11.i48.7560.
6
[Assessment and current treatment of portal hypertension].
Korean J Hepatol. 2005 Sep;11(3):211-7.
8
Acute hemodynamic effects of octreotide and terlipressin in patients with cirrhosis: a randomized comparison.
Am J Gastroenterol. 2005 Mar;100(3):631-5. doi: 10.1111/j.1572-0241.2005.41381.x.
9
Relationship of hemodynamic indices and prognosis in patients with liver cirrhosis.
Korean J Intern Med. 2004 Sep;19(3):165-70. doi: 10.3904/kjim.2004.19.3.165.
10

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验