Pringle S D, McKee R F, Garden O J, Lorimer A R, Carter D C
University Department of Medical Cardiology, Royal Infirmary, Glasgow, UK.
Aliment Pharmacol Ther. 1988 Oct;2(5):451-9. doi: 10.1111/j.1365-2036.1988.tb00718.x.
Current interest in the pharmacological manipulation of portal pressure centres on the long-acting somatostatin analogue SMS 201-995. Nine haemodynamically stable cirrhotic patients who had previously bled from oesophageal varices had wedged and free hepatic venous pressures and cardiac index measured, using a Swan-Ganz catheter, before and at 60, 120 and 180 min after beginning a 60-min infusion of 25 microgram/h of SMS 201-995. Seven clinically similar patients had the same measurements performed without SMS 201-995. In all patients cardiac index was found to decrease and systemic vascular resistance increase at 60 min, although heart rates and arterial blood pressures were unchanged. The group given SMS 201-995 was significantly different from the control group in sustaining a fall in wedged hepatic venous pressure and trans-hepatic venous gradient at 60 min. SMS 201-995 causes a fall in portal pressure without a significant systemic haemodynamic effect.
目前对于门静脉压力的药物调控研究主要集中在长效生长抑素类似物SMS 201-995上。9例血流动力学稳定且既往有食管静脉曲张出血史的肝硬化患者，在开始以25微克/小时的速度静脉输注SMS 201-995 60分钟前、输注开始后60分钟、120分钟及180分钟时，使用Swan-Ganz导管测量其楔入肝静脉压、自由肝静脉压及心脏指数。7例临床情况相似的患者在未使用SMS 201-995的情况下进行相同测量。在所有患者中，尽管心率和动脉血压未变，但在60分钟时均发现心脏指数下降，全身血管阻力增加。在60分钟时，接受SMS 201-995治疗的组在维持楔入肝静脉压及肝静脉跨压下降方面与对照组有显著差异。SMS 201-995可使门静脉压力下降，而对全身血流动力学无显著影响。
