丹参对门脉高压血流动力学影响的实验与临床研究

EFFECTS OF RADIX SALVIAE MILTIORRHIZAE ON HEMODYNAMICS OF PORTAL HYPERTENSION: CLINICAL AND EXPERIMENTAL STUDY

为研究丹参对肝硬化门脉血流动力学的影响，利用血管插管测定用药前后胆管结扎肝硬化犬门脉系统压力变化，超声多普勒监测肝硬化患者用药后门静脉系统血流动力的改变。结果：（１）丹参静脉给药可使肝硬化犬门静脉压（ＰＰＶ）、嵌塞肝静脉压（ＷＨＶＰ）、肝静脉压力梯度（ＨＶＰＧ）显著降低（Ｐ＜０．０５～０．０１），而平均动脉压（ＭＡＰ）、心率（ＨＲ）无明显变化（Ｐ＞０．０５）；（２）丹参长期口服（１０～１２周），可显著降低肝硬化患者（Ｃｈｉｌｄ－ＰｕｇｈＡ、Ｂ级）门静脉内径（ＤＰＶ）、脾静脉内径（ＤＳＶ）、门静脉血流量（ＱＰＶ）、脾静脉血流量（ＱＳＶ）（Ｐ＜０．０５～０．０１），并对患者乏力、厌食、腹胀及肝功能（ＡＬＴ）具有部分改善作用，未见副作用。本研究表明，丹参为安全有效的降低门静脉压力药物，值得对其做进一步研究。

By measuring portal pressure of hepatocirrhotic dogs of bile duct ligation directly, and detecting portal system flow in patients with hepatic cirrhosis by ultrasound doppler, we studied the portal hemodynamic effects of Radix Salviae Miltiorrhizae (RSM). After intravenous administration of RSM in hepatocirrhotic dogs, the portal venous pressure (P PV ), wedge hepatic venous pressure (WHVP), and hepatic venous pressure gradient (HVPG) were significantly decreased ( P <0.05～0.01), but the mean arterial pressure (MAP), and heart rate (HR) unchanged ( P >0.05). After long term administration of RSM (10～12 weeks), the diameter of portal vein (D PV ) and splenic vein (D SV ), the flow of portal vein (Q PV ), and splenic vein (Q SV ) in patients with hepatic cirrhosis were significantly decreased respectively ( P <0.05～0.001). Hypodynamia, abdominal distension, anorexia and liver function (ALT) were improved partially after administration of RSM in patients with hepatic cirrhosis. Side effects of RSM were not found. The results demonstrated that RSM is an effective drug of depressing portal pressure with few side effects.