Queuniet A M, Czernichow P, Lerebours E, Ducrotte P, Tranvouez J L, Colin R
Gastroenterol Clin Biol. 1987 Jan;11(1):41-7.
The aim of this study was to assess, by a pragmatic controlled trial, the value of propranolol in the prevention of recurrent bleeding in patients with cirrhosis. From January 1982 to December 1984, 368 cirrhotic patients were admitted for bleeding episode due to portal hypertension. Ninety-nine patients were included in the trial 24 h after cessation of bleeding (5 days on the average after hospital admission) and were randomly assigned to 2 groups: 51 patients receiving propranolol at doses that reduced the resting heart rate by 25 p. 100 and 48 receiving neither treatment nor placebo. Ninety-one per cent presented a rupture of varices, and 9 p. 100 acute gastric erosions: 94 p. 100 had an alcoholic cirrhosis. The distribution according to Child Turcotte's classification was grade A: 45.5 p. 100, B: 45.5 p. 100, C: 100 p. 100. The two groups were not significantly different excepted for previous bleeding episodes. The cumulative percentages of recurrent bleeding were not significantly different: between the treated and untreated groups (60 p. 100 vs. 68 p. 100 at 18 months); between the compliant patients (n = 39) and untreated and not compliant patients altogether; between the treated and untreated patients of Child's grade A on the one hand, and patients grades B and C on the other hand. The curves of cumulative survival were not significantly different between treated and untreated patients (66 p. 100 vs. 78 p. 100 at 18 months).(ABSTRACT TRUNCATED AT 250 WORDS)
本研究旨在通过一项实用的对照试验，评估普萘洛尔在预防肝硬化患者复发性出血方面的价值。从1982年1月至1984年12月，368例肝硬化患者因门静脉高压导致出血发作而入院。99例患者在出血停止后24小时（平均入院后5天）被纳入试验，并被随机分为两组：51例患者接受能使静息心率降低25%的剂量的普萘洛尔治疗，48例患者既不接受治疗也不接受安慰剂。91%的患者出现静脉曲张破裂，9%出现急性胃黏膜糜烂；94%患有酒精性肝硬化。根据Child-Turcotte分类，分布情况为：A级45.5%，B级45.5%，C级10%。除既往出血发作情况外，两组无显著差异。复发性出血的累积百分比无显著差异：治疗组与未治疗组之间（18个月时分别为60%和68%）；依从患者（n = 39）与未治疗且不依从患者之间；Child A级的治疗组与未治疗组患者，与B级和C级患者之间。治疗组与未治疗组患者的累积生存曲线无显著差异（18个月时分别为66%和78%）。（摘要截断于250字）
