奥曲肽和垂体后叶素对门脉高压血流动力学的影响

EFFECTS OF OCTREOTIDE AND PITUITRIN ON HEMODYNAMICS IN PATIENTS WITH PORTAL HYPERTENSION

应用９９ｍＴｃ－ＭＩＢＩ测定心／肝放射性摄取比值（Ｈ／Ｌ比值），脉冲多普勒超声检测门脉主干的血流量、血流流速及其内径，比较奥曲肽和垂体后叶素对肝硬化门脉高压患者的肝血流动力学的影响。结果示：二药对肝血流动力学改变可致门脉压降低，有利于破裂的食管曲张静脉凝血和止血。二药相比：Ｈ／Ｌ比值下降和门脉主干血流量减少亦有显著差异（分别为Ｐ＜０．０５和ｐ＜０．０１）。应用奥曲肽时未出现副作用，而应用垂体后叶素时１５例（４２％）出现短暂腹痛和排便感。本研究结果提示，奥曲肽对降低门脉血流及压力似较垂体后叶素为优，且无副作用。

his study aims at comparing the effects of octreotide and pituitrin on hepatichemodynamics in patients with portal hypertension by determining blood flow,flow rate andcalibre of portal vein stem with99mTc-MIBI assay, as well as heart/liver radioisotope uptakeratio and pulsed doppler ultrasonography. The results showed that the hemodynamic changescaused by the 2 medicines led to a lowering of portal pressure and would be helpful incoagulation and hemostasis of the ruptured esophageal varices。 The 2 medicines differedsignificantly in their ability to lower H/L ratio and blood flow of portal vein stem(P< 0.05and P< 0.01) respectively. No adverse reaction occurred in octreotide-treated cases, whereasin those who were treated with pituitrin,transient abdominal pain and desire of defecationoccurred in 42 % of the cases. These results suggest that octreotide is superior to pituitrin in lowering portal blood flowand portal pressure and with no adverse effect。