硝酸异山梨酯气雾剂对门静脉血流动力学的影响

Effects of isosorbidi dinitras spray on pytic hemodynamics

探讨硝酸异山梨酯以气雾剂的形式应用对门静脉血流动力学的影响。于1999年2月～1999年11月选择肝硬化门脉高压患者31例,利用无创伤自身对照的方法,用彩色超声多普勒检测患者的门静脉直径、血流速度、血流量,脾静脉直径、血流速度及血流量,然后向患者口腔内喷入硝酸异山梨酯气雾剂(商品名:欣舒气雾剂,山东省医药工业研究所制药厂生产)4喷(约含药量2.5mg),于用药后1分钟、10分钟、30分钟再分别检测以上项目,并进行统计学处理。用硝酸异山梨酯气雾剂后可缩小肝硬化门脉高压患者的门静脉直径、降低门脉血流速度、减少门脉血流量(P<0.01),因而可降低门脉压力,对患者的血压和脉搏无显著影响(P>0.05)其它副作用轻微,并且在1分钟内起效,持续半小时以上。提示:硝酸异山梨酯气雾剂可快速降低门静脉压力,从而提出将硝酸异山梨酯以气雾剂的形式用于预防和治疗肝硬化门静脉高压引起的上消化道出血。

To probe effects on pylic hemodynamics of icocorbidi dinitras administered in form of spray. The 31 patients with portal hypertension due to cirrhosis were selected to undergo non - trauma ego - contrast research method, which means that parameters as pylic diameter, blood flow velocity and volume, splenic vein diameter, blood flow velocity and volume were measured with Color Doppler Ultrasonography before and after mouth - spray administration of isosorbidi dinitras at 1 min, 10min and 30min. (Goods name: Xinshu Spray, a product of Shandong Medical & Pharmaceutical Institute). Dose of administration was 4 times of spray containing about 2.5mg isosorbidi dinitras. Data had been statistically analyzed. Administration of isosofbidi dinitras was able to narrow the patients' pylic diameter, slowed blood velocity and decreased blood volume in pylic vein (P< 0.01), owing to which patients' pylic pressure decreased. While no obvious effects on patients' blood pressure and puke, as well as other side effects and been detected ( P > 0.05). Effects of isosorbidi dinitrsa worked within 1 min after administration and lasted for over a half hour. Isosorbidi Dinitras Spray can decrease pylic pressure at a high speed and isosorbidi dinitras in form of spray is recommendable for prevention and treatment of upper gastrointestinal hemorrhage caused by pylic hypertension due to cirrhosis.