丹参酮ⅡA磺酸钠对门脉高压症合并食管静脉曲张患者的临床疗效研究

Effect of tanshinone ⅡA sodium injection in the treatment of portal hypertension patients with esophageal varices

目的观察丹参酮ⅡA磺酸钠注射液治疗门脉高压症合并食管静脉曲张的临床疗效及其对血管紧张素Ⅱ、血流动力学的影响。方法 120例门脉高压症合并食管静脉曲张破裂出血的患者随机分为试验组和对照组,各60例。试验组静脉滴注丹参酮ⅡA磺酸钠注射液40~80 mg·d^(-1),5%葡萄糖注射液或0.9%氯化钠注射液250~500 mL稀释,每天1次;对照组静脉滴注奥曲肽100μg,再以25μg·L^(-1)持续静脉滴注,维持1~3 d。2组均治疗14 d。比较2组治疗后的临床疗效、血管紧张素Ⅱ、血流动力学变化和不良反应发生情况。结果治疗后,试验组总有效率为86.67%,显著高于对照组的58.34%(P<0.05)。治疗后,试验组血管紧张素Ⅱ、门静脉主干和脾静脉的内径、血流速度、血流量均显著降低(P<0.05);试验组显著低于对照组(P<0.05)。试验组不良反应发生率为3.33%(2/60),对照组不良反应发生率为10.00%(6/60,P<0.05)。结论丹参酮ⅡA磺酸钠对门脉高压症合并食管静脉曲张有一定的临床疗效,不良反应发生率低。

Objective To investigate the clinical efficacy of sodium tanshinone ⅡA in the treatment of portal hypertension patients with esophageal varices and its impact on angiotensinⅡ and hemodynamic. Methods A total of 120 patients with portal hypertension（ PHT） and esophageal varices（ EVB） were randomly divided into treatment group and control group,60 cases in each group. Patients in treatment group were treated with tanshinone ⅡA sodium injection 40- 80 mg·d^（-1）,5% dextrose injection or 0. 9% sodium chloride injection 250- 500 mL dilution. Patients in control group were treated with octreotide 100 μg intravenous infusion,then 25 μg·L^（-1）continuous infusion to maintain 1- 3 d. All patients were treated for 14 d. Clinical efficacy,angiotensin Ⅱ（ AngⅡ）,hemodynamics and adverse reactions were observed between the two groups. Results Clinical efficiency of treatment group was 86. 67%,significantly higher than that in control group, which was 58. 34%（ P〈0. 05）. After treatment,the AngⅡ,main portal vein（ MPV） and splenic vein（ SV） of diameter,flow velocity,blood flow in treatment group had significant difference with before treatment and control group（ P〈0. 05）. The incidence of adverse reactions in treatment group and control group were 3. 33%（ 2 /60）,10. 00%（ 6 /60）,with significant difference（ P〈0. 05）. Conclusion The clinical efficiency of tanshinone ⅡA sodium on patients with esophageal varices and portal hypertension was significant,with low incidence of adverse reactions.