Westaby D, Melia W M, Macdougall B R, Hegarty J E, Gimson A E, Williams R
Gut. 1985 Apr;26(4):421-5. doi: 10.1136/gut.26.4.421.
Oral metoprolol, in a dose sufficient to reduce resting pulse rate by 25%, was compared with repeated injection sclerotherapy for the long term management of variceal bleeding. The prospective, randomised study was undertaken in 32 patients with biopsy proven cirrhosis and variceal bleeding who were Grade A or B on a modified Child's classification. In the 15 patients receiving metoprolol, portal pressure showed a mean fall of 3.7 mmHg (17.3 +/- 1.2 to 13.6 +/- 1.2 mmHg, p less than 0.01) after four weeks of continuous therapy, as compared with pretreatment levels. Nine of the 15 patients taking metoprolol had further bleeding (total of 21 episodes) compared with six of 17 in the sclerotherapy group (nine episodes). The risk of bleeding per patient/month of follow up was three times higher in the metoprolol group compared with those treated by sclerotherapy (0.14 and 0.04 respectively, p less than 0.025). Rebleeding in the metoprolol group occurred in six of the patients who had a fall in portal pressure of 10% or more.
将口服美托洛尔（剂量足以使静息心率降低25%）与反复注射硬化疗法用于静脉曲张出血的长期管理进行比较。这项前瞻性随机研究纳入了32例经活检证实为肝硬化且静脉曲张出血的患者，这些患者根据改良Child分级为A或B级。在15例接受美托洛尔治疗的患者中，连续治疗四周后，门静脉压力与治疗前水平相比平均下降了3.7 mmHg（从17.3±1.2 mmHg降至13.6±1.2 mmHg，p<0.01）。15例服用美托洛尔的患者中有9例再次出血（共21次发作），而硬化疗法组17例中有6例再次出血（9次发作）。美托洛尔组每位患者随访每月的出血风险比硬化疗法治疗的患者高3倍（分别为0.14和0.04，p<0.025）。美托洛尔组中门静脉压力下降10%或更多的患者中有6例再次出血。
