缬沙坦治疗肝硬化门静脉高压症的临床分析

Clinical analysis of Valsartan on portal hypertension in patients with hepatic cirrhosis

目的该实验通过观察缬沙坦对肝硬化患者血流动力学及肝肾功能等指标的影响,探讨其降门静脉压的作用及其安全性。方法选取40例肝硬化患者,将其随机分为对照组和治疗组各20例,对照组给予常规治疗,治疗组在常规治疗基础上加用缬沙坦80 mg/d口服,疗程为1个月。治疗前后应用彩色多普勒超声仪检测门、脾静脉的内径与流速,整个用药过程中观察患者的血压和心率,监测血常规和肝、肾功能。结果治疗组患者门、脾静脉的内径减小,流速增快,差异有统计学意义(P<0.05),而对照组治疗前后上述指标虽有变化,但差异无统计学意义。应用缬沙坦后,患者的血压和心率无明显变化,血常规和肝、肾功能无明显损害(P>0.05)。结论缬沙坦可通过减小门脾静脉内径,提高血流速度,从而起到降低门静脉压力的作用。同时对血压和心率无明显影响,对血常规和肝、肾功能也无明显损害。

【Objective】 To study the mechanism of Valsartan in reducing portal hypertension by observing the effects of Valsartan on hemodynamic markers,hepatic,renal function and investigate its safety.【Methods】 Forty patients with hepatic cirrhosis were divided into control group and observation group randomly.The control group（20） received routine treatment for 1 month and 20 patients in observation group received Valsartan 80 mg/d based on routine treatment for the same time.Diameter of portal or splenic vein and their mean velocity were measured before and after treatment by Color Doppler Ultrasonography.During the whole observation period,the blood pressure,heart rate of all the patients was observed,and blood routine,liver and renal functions were monitored.【Results】 Valsartan reduced the diameter of portal or splenic vein and increased the mean velocity of portal or splenic vein.The differences is significant statistically（P 0.05） after treatment in observation group,but no significance in control group.After the application of Valsartan,blood pressure and heart rate in patients did not change obviously,and blood routine examination,liver and renal functions were not worsened significantly.【Conclusion】 Valsartan can decrease portal hypertension by reducing the diameter of portal or splenic vein and increasing its mean velocity.At the same time,it had no significant side effect to blood pressure or heart rate,moreover,liver and renal functions are also not damaged significantly.