Sansoè G, Ferrari A, D'Alimonte P, Trenti T, Zoboli P, Romagnoli R, Villa E, Manenti F
Department of Internal Medicine, University of Modena, Italy.
Am J Gastroenterol. 1998 Mar;93(3):429-33. doi: 10.1111/j.1572-0241.1998.00429.x.
Dipyridamole is a vasodilator that inhibits the cellular uptake of adenosine, which physiologically reduces the resistance to hepatic arterial flow inside the liver. This study aims at assessing the acute effect of dipyridamole on functional liver plasma flow (measured as the extrarenal sorbitol clearance) and on the Doppler US Congestion Index of the portal vein (the ratio between the cross-sectional area of this vein and the mean velocity of portal flow), which correlates with the severity of portal hypertension.
We have determined the extrarenal sorbitol clearance (14 cases) and the Congestion Index (seven cases) before and at 30, 60, and 90 min after the oral administration of 25 mg dipyridamole in patients with liver cirrhosis. We also measured the effect of dipyridamole on functional liver plasma flow in six healthy subjects.
Dipyridamole increased the extrarenal sorbitol clearance in controls (+17%, p < 0.01) and in cirrhotic patients (+15%, p < 0.01). The drug decreased the portal Congestion Index in all patients, averaging -24% (p < 0.05) 90 min after its oral administration.
This result was due both to a mean decrease of the portal sectional area and to a mean increase in portal flow velocity. In conclusion, these data suggest that dipyridamole should decrease the vascular resistance to portal flow in cirrhosis; this effect may be mediated by an adenosine-dependent vasodilation in the intrahepatic site or along the portosystemic collaterals.
双嘧达莫是一种血管扩张剂，可抑制腺苷的细胞摄取，而腺苷在生理上可降低肝脏内肝动脉血流的阻力。本研究旨在评估双嘧达莫对功能性肝血浆流量（以肾外山梨醇清除率衡量）以及门静脉多普勒超声充血指数（该静脉横截面积与门静脉平均流速之比，与门静脉高压的严重程度相关）的急性影响。
我们测定了肝硬化患者口服25mg双嘧达莫前以及服药后30、60和90分钟时的肾外山梨醇清除率（14例）和充血指数（7例）。我们还测量了双嘧达莫对6名健康受试者功能性肝血浆流量的影响。
双嘧达莫使对照组的肾外山梨醇清除率增加（+17%，p<0.01），肝硬化患者增加（+15%，p<0.01）。该药物使所有患者的门静脉充血指数降低，口服后90分钟平均降低-24%（p<0.05）。
这一结果是由于门静脉横截面积平均减小以及门静脉流速平均增加所致。总之，这些数据表明双嘧达莫可降低肝硬化时门静脉血流的血管阻力；这种作用可能是由肝内部位或门体侧支循环中依赖腺苷的血管舒张介导的。
