临床肝胆病杂志Issue(1)：114-118,5.DOI:10.3969/j.issn.1001-5256.2016.01.021
卡维地洛与普萘洛尔降低肝硬化门静脉高压患者肝静脉压力梯度效果的对比分析
A comparative analysis of carvedilol and propranolol in hepatic venous pressure gradient reduction in patients with cirrhotic portal hypertension
李晶 1孙东杰 1王广川 1冯华 1史永军 1张春清1
作者信息
- 1. 山东大学附属省立医院 消化科，济南250021
- 折叠
摘要
Abstract
Objective Toinvestigatethedifferencesbetweencarvedilolandpropranololinthedegreeofhepaticvenouspressuregradient (HVPG)reduction,response rate,and adverse events in patients with cirrhotic portal hypertension,and to evaluate the efficacy and safety of carvedilolinreducingportalveinpressure.Methods Sixty-fourpatientswithcirrhoticportalhypertensionwhowerediagnosedandtreatedin Shandong Provincial Hospital from October 2010 to January 2012 were selected and randomized into propranolol group (n=33)and carvedilol group (n=31).The dose of drugs was adjusted according to blood pressure and heart rate,and the course of treatment was 7 days.Measure-ments of HVPG and liver and renal function indices were performed before and after treatment,and the degree of HVPG reduction and response rate were compared between the two groups.The incidence of adverse events such as hypotension,ascites,and renal injury in the two groups was observed.Comparison of continuous data between the two groups was made by t test,and comparison of categorical data was made by chi-square testorFisher′sexact.Results HVPGwasreducedsignificantlyinbothcarvedilolgroupandpropranololgroup,withdegreesof(28.30± 22.19)% and (12.38 ±24.09)%,respectively,and the reduction in the carvedilol group was significantly greater/higher/larger (t =0.223 4,P=0.032).The response rate was 56.7%(17/30)and 41.9%(13/31)in the carvedilol group and propranolol group,respec-tively,with no significant difference between the two groups (χ2 =1.324,P=0.250).The carvedilol group had a significantly more reduc-tion in mean arterial pressure (MAP)than the propranolol group (t=2.338,P=0.024),but the patients did not experience the adverse e-vent of hypotension.The levels of bilirubin,serum creatinine,and urea nitrogen did not change significantly before and after treatment,and therewasnotendencyofascitesformationoraggravation.Conclusion Thisrandomizedstudysuggeststhatwithinashortperiodoftime, carvedilol is more effective than propranolol in reducing HVPG and has no obvious adverse effects.Carvedilol is safe and effective in the treatment of cirrhotic portal hypertension.关键词
肝硬化/高血压,门静脉/普萘洛尔/卡维地洛Key words
liver cirrhosis/hypertension,portal/propranolol/carvedilol分类
医药卫生引用本文复制引用
李晶,孙东杰,王广川,冯华,史永军,张春清..卡维地洛与普萘洛尔降低肝硬化门静脉高压患者肝静脉压力梯度效果的对比分析[J].临床肝胆病杂志,2016,(1):114-118,5.
