Boulétreau P, Bret M, Meunier J, Ray M J, Chossegros P, Trépo C, Tête R, Brette R
Gastroenterol Clin Biol. 1984 Mar;8(3):255-9.
The purpose of this work was to study the hemodynamic effects of a pituitary extract (Post-Hypophyse, Choay, EPH) and of lysine vasopressin (Diapid, Sandoz, VP). Cardiac, pulmonary and liver hemodynamics were measured in 50 cirrhotic patients before and during intravenous infusion (0.45 IU/kg/h) of EPH (24 patients) or VP (26 patients). EPH and VP did not have identical consequences in cardiac output and systemic resistances. EPH significantly increased cardiac output and significantly decreased systemic resistances while VP significantly and increased systemic resistances. Both vasoactive drugs similarly decreased myocardial performances. EPH and VP had a moderate influence on WHV/IVC pressure gradient. This was variable from one patient to another. The decrease of WHV/IVC pressure gradient observed during EPH infusion was mainly related to an increase of IVC pressure. Since the effects of both drugs on WHV/IVC pressure gradient are slight and unpredictable and they exert an important effect on cardiopulmonary hemodynamics, caution should be taken in administering EPH or VP to cirrhotic patients. The clinical use of EPH or VP should be undertaken only when cardiac and liver hemodynamics monitoring are available.
本研究旨在探讨垂体提取物（垂体后叶素，乔雅公司生产，EPH）和赖氨酸加压素（必压生，山德士公司生产，VP）的血液动力学效应。对50例肝硬化患者在静脉输注EPH（24例）或VP（26例）前及输注过程中（0.45 IU/kg/h）测量心脏、肺和肝脏的血液动力学。EPH和VP对心输出量和全身阻力的影响并不相同。EPH显著增加心输出量并显著降低全身阻力，而VP则显著增加全身阻力。两种血管活性药物均同样降低心肌功能。EPH和VP对肝静脉楔压/下腔静脉压力梯度有中度影响。这种影响因患者而异。输注EPH期间观察到的肝静脉楔压/下腔静脉压力梯度降低主要与下腔静脉压力升高有关。由于两种药物对肝静脉楔压/下腔静脉压力梯度的影响轻微且不可预测，并且它们对心肺血液动力学有重要影响，因此在给肝硬化患者使用EPH或VP时应谨慎。仅当有心脏和肝脏血液动力学监测时，才可使用EPH或VP进行临床治疗。
