多普勒彩超评估甲氧乙心安联合硝酸异山梨醇酯治疗门静脉高压的效果

Efficacy of Metoprolol Combined with Isosorbide Dinitrate in the Treatment of Portal Hypertension Evaluated by Colour Doppler Ultrasonography

目的：评估甲氧乙心安（商品名：倍他乐克）联合硝酸异山梨醇酯（商品名：消心痛）预防肝硬化患者上消化道出血和再出血的效果与安全性。方法：应用多普勒彩超检测２２例肝硬化门静脉高压患者经倍他乐克联合消心痛治疗前后门静脉系统血流动力学变化，并观察治疗前后血压、心率及肝功能变化。结果：治疗前门静脉主干、脾静脉及肠系膜上静脉平均内径较正常组明显增宽，平均血流速度明显减慢，平均血流量明显增多。治疗后三者平均内径无明显变化（Ｐ＞０．０５），但与治疗前比较，平均流速明显减慢，平均血流量明显减少（Ｐ＜０．０５）。结论：倍他乐克联合消心痛降门静脉压治疗安全有效。多普勒彩超对门静脉高压的诊断和治疗评估有重要意义。

Background/Aims: To observe the efficacy and safety of metoprolol combined with isosorbide dinitrate in the prevention of upper gastrointestinal bleeding and rebleeding in cirrhotic patients. Methods: Changes of the portal hemodynamics were measured with colour doppler ultrasonography in 22 patients with liver cirrhosis before and after treatment of metoprolol combined with isosorbide dinitrate. Changes of the blood pressure, heart rate and liver function tests were observed before and after treatment. Results: The mean internal diameters of the main portal vein (MPV), splenic vein (SV) and superior mesenteric vein (SMV) were remarkably dilated, the mean flow velocity was significantly decreased, and the mean flow volume was significantly increased before treatment as compared to that in normal subjects. The mean internal diameters of MPV, SV and SMV had no significant difference (P> 0.05), but the mean flow velocity was significantly slower, and the mean flow volume was significantly decreased after treatment in patients with cirrhosis(p<0.05). Conclusions: Metoporlol combined with isosorbide dinitrate is effective and safe in the treatment of portal hypertension. Colour doppler ultrasonography is useful for evaluation of portal hypertension before and after treatment.