维拉帕米和硝苯地平对乙肝表面抗原阳性肝硬化腹水患者肝脏吲哚菁绿清除率的影响。

The influence of verapamil and nifedipine on hepatic indocyanine green clearance in patients with HBsAg-positive cirrhosis and ascites.

作者信息

Lay C S, Tsai Y T, Kong C W, Lee F Y, Chang T T, Lin H C, Yang C M, Lee S D, Chiang B N, Lo K J

机构信息

Division of Gastroenterology, Veterans General Hospital National Defense Medical Center, Taipei, Taiwan, Republic of China.

出版信息

Clin Pharmacol Ther. 1988 Oct;44(4):453-7. doi: 10.1038/clpt.1988.179.

DOI:10.1038/clpt.1988.179

PMID:3168396

Abstract

The influence of verapamil and nifedipine on hepatic indocyanine green kinetics was studied in 12 patients with HBsAg-positive cirrhosis and ascites. Hepatic clearance and its two biologic determinants, hepatic blood flow and metabolic activity (intrinsic clearance [maximum velocity/metabolite elimination rate constant, or Vmax/km]), were determined from hepatic indocyanine green elimination at steady state in patients with cirrhosis. Acute intravenous administration 10 mg verapamil significantly increased the hepatic indocyanine green blood flow (p less than 0.05), but significantly decreased the hepatic clearance (p less than 0.05), extraction ratio (p less than 0.05) and Vmax/km (p less than 0.05). However, acute sublingual administration of 10 mg nifedipine resulted in no significant change in any parameters of hepatic elimination function. These results show that verapamil, but not nifedipine, might impair the transhepatic extraction activity of hepatocytes in patients with HBsAg-positive cirrhosis and ascites.

摘要

在12例乙肝表面抗原阳性的肝硬化腹水患者中，研究了维拉帕米和硝苯地平对肝脏吲哚菁绿动力学的影响。通过肝硬化患者稳态时肝脏吲哚菁绿的消除情况，测定肝脏清除率及其两个生物学决定因素，即肝血流量和代谢活性（内在清除率[最大速度/代谢物消除速率常数，或Vmax/km]）。急性静脉注射10mg维拉帕米可显著增加肝脏吲哚菁绿血流量（p<0.05），但显著降低肝脏清除率（p<0.05）、提取率（p<0.05）和Vmax/km（p<0.05）。然而，急性舌下含服10mg硝苯地平后，肝脏消除功能的任何参数均无显著变化。这些结果表明，维拉帕米而非硝苯地平可能损害乙肝表面抗原阳性的肝硬化腹水患者肝细胞的经肝提取活性。