中国临床药理学杂志2024，Vol.40Issue(18)：2645-2649,5.DOI:10.13699/j.cnki.1001-6821.2024.18.008
卡维地洛、普萘洛尔治疗肝硬化食管静脉曲张出血患者再出血的临床研究
Clinical trial of carvedilol and propranolol in the treatment of rebleeding in patients with cirrhosis and esophageal variceal bleeding
摘要
Abstract
Objective To investigate the value of carvedilol or propranolol in preventing rebleeding in patients with esophageal variceal bleeding(EVB)in liver cirrhosis.Methods Patients with EVB in liver cirrhosis were divided into the treatment group and the control group.The treatment group was treated with oral administration of carvedilol dispersible tablets,with an initial dose of 6.25 mg,bid.The control group was treated with oral administration of propranolol hydrochloride tablets,with an initial dose of 20 mg,bid.The treatment course of two groups was 1 year.The effects between two groups were compared.The rebleeding rate,and hemodynamics between two groups were compared treated after 6 months and 1 year of treatment.Safety that occurred during treatment were observed.Results The treatment group consisted of 64 patients,while the control group consisted of 61 patients.After treatment,the overall response rate in the treatment group was 93.75％(60 cases/64 cases),while the control group was 91.80％(56 cases/61 cases),without statistically significant difference between the groups(all P＞0.05).After 6 months of treatment,rebleeding rates in the treatment group and the control group were 4.69％(3 cases/64 cases)and 9.84％(6 cases/61 cases),without statistically significant difference between the groups(P＞0.05).After 1 year of treatment,rebleeding rates in the treatment group and the control group were 10.94％(7 cases/64 cases)and 24.59％(15 cases/61 cases),without statistically significant difference between the groups(P＜0.05).After 6 months of treatment,portal vein diameter(PVD)in the treatment group and the control group were(12.39±2.41)and(13.88±1.76)mm;splenic vein diameter(SVD)were(7.56±1.52)and(8.35±1.69)mm;mean blood flow velocity of portal vein(Vp)were(35.26±7.04)and(38.12±7.60)cm·s-1;mean blood flow velocity of splenic vein(Vs)were(20.03±4.11)and(22.34±4.69)cm·s-1.Compared with control group,the above indexes of treatment group had statistical significance(all P＜0.05).After 1 year of treatment,PVD in the treatment group and the control group were(11.87±2.52)and(13.15±2.04)mm;SVD were(7.33±1.48)and(8.22±1.55)mm;Vp were(33.96±6.75)and(37.46±6.83)cm·s-1;Vs were(19.26±4.33)and(21.55±4.47)cm·s-1.Compared with control group,the above indexes of treatment group had statistical significance(all P＜0.05).Adverse drug reactions in the treatment group included bradycardia,hypotension,dizziness,nausea and vomiting,while adverse reactions in the control group included bradycardia,hypotension,dizziness,drowsiness,nausea and vomiting,and skin rash.The total incidence of adverse drug reactions in the treatment group was 12.50％,while the control group was 27.87％,the differences were statistically significant(P＜0.05).Conclusion Compared to propranolol,carvedilol can better prevent rebleeding and relieve esophageal varices.关键词
卡维地洛分散片/盐酸普萘洛尔片/肝硬化/食管静脉曲张/出血Key words
carvedilol dispersible tablets/propranolol hydrochloride tablets/liver cirrhosis/esophageal varices/bleeding分类
医药卫生引用本文复制引用
闭玉华,徐辉,乔丽娟,温建儒..卡维地洛、普萘洛尔治疗肝硬化食管静脉曲张出血患者再出血的临床研究[J].中国临床药理学杂志,2024,40(18):2645-2649,5.基金项目
四川省中医药管理局科学基础研究基金资助项目(2018QN0419) （2018QN0419）
