Bołdys H, Hartleb M, Rudzki K, Nowak A, Nowak S
Katedry i Kliniki Gastroenterologii, Slaskiej Akademii Medycznej w Katowicach.
Pol Arch Med Wewn. 1994 Jul;92(1):19-25.
Propranolol can reduce portal hypertension, therefore is recommended in prevention of variceal bleeding in patients with liver cirrhosis. However, in certain patients with cirrhosis portal hypotensive effect of propranolol cannot be obtained, and the reason of this finding is unknown. In 28 patients with cirrhosis the effect of seven days administration of propranolol on collateral blood flow from inferior mesenteric vein was examined by means of per-rectal portal scintigraphy. Portosystemic shunt index was significantly reduced by propranolol by 17.4 +/- 4.8%. This reduction was observed in cirrhotics classified to A and B, but not C Child-Pugh. These data suggest that propranolol increases vascular resistance in portosystemic circulation which depends on severity of liver failure. This mechanism opposes reduction of portal pressure.
普萘洛尔可降低门静脉高压，因此推荐用于预防肝硬化患者的静脉曲张出血。然而，某些肝硬化患者无法获得普萘洛尔的门静脉降压效果，这一发现的原因尚不清楚。通过直肠门静脉闪烁显像法，对28例肝硬化患者给予普萘洛尔7天，观察其对肠系膜下静脉侧支血流的影响。普萘洛尔使门体分流指数显著降低了17.4±4.8%。在Child-Pugh分级为A和B级的肝硬化患者中观察到了这种降低，但C级患者未观察到。这些数据表明，普萘洛尔增加了门体循环中的血管阻力，这取决于肝衰竭的严重程度。这种机制与门静脉压力的降低相反。
