Gatta A, Merkel C, Sacerdoti D, Bolognesi M, Caregaro L, Zuin R, Angeli P, Ruol A
Digestion. 1987;37(1):22-8. doi: 10.1159/000199483.
Nadolol, a nonselective beta-blocker, has been shown to decrease portal pressure in patients with cirrhosis at the same degree as propranolol. No data are available, however, about its effect on rebleeding rate and mortality in patients undergoing prevention of rebleeding from esophageal varices. A prospective randomized clinical trial was performed in patients with cirrhosis who survived a documented episode of variceal hemorrhage. 12 patients received nadolol, 12 placebo. Patients with child's C grade, tense ascites, renal failure, contraindications to beta-blocker, or age greater than 70 were not included. After a follow-up of up to 145 weeks, 9 patients in the nadolol group and 4 in the placebo group survived free from rebleeding (log-rank test: chi 2 = 4.35, p less than 0.05). Survival was not statistically different in the two groups (1 death in the nadolol group, 3 in the placebo group). In conclusion, nadolol appears to represent an effective therapy in the prevention of variceal rebleeding in cirrhotic patients.
纳多洛尔是一种非选择性β受体阻滞剂，已证明其降低肝硬化患者门静脉压力的程度与普萘洛尔相同。然而，关于其对预防食管静脉曲张再出血患者的再出血率和死亡率的影响，尚无相关数据。对经历过一次有记录的静脉曲张出血且存活下来的肝硬化患者进行了一项前瞻性随机临床试验。12名患者接受纳多洛尔治疗，12名患者接受安慰剂治疗。不包括Child's C级、有张力性腹水、肾衰竭、β受体阻滞剂禁忌证或年龄大于70岁的患者。经过长达145周的随访，纳多洛尔组有9名患者、安慰剂组有4名患者存活且未再出血（对数秩检验：χ2 = 4.35，p < 0.05）。两组的生存率无统计学差异（纳多洛尔组1例死亡，安慰剂组3例死亡）。总之，纳多洛尔似乎是预防肝硬化患者静脉曲张再出血的一种有效疗法。
