甲氰咪胍对肝硬变门静脉高压症患者门静脉压力影响的初步观察

PRELIMINARY OBSERVATON OF THE EFFECT OF CIMETIDINE ON PORTAL VENOUS PRESSURE IN CIRRHOTIC PATIENTS WITH PORTAL HYPERTENSION

肝硬变时血中组织胺等液递物质含量增加,并促使门静脉压力(PVP)升高。本文观察了组织胺受体拮抗剂甲氰咪胍对肝硬变门静脉高压症患者PVP的影响,发现经周围静脉一次快速推注甲氨咪胍0.2g使肝硬变门静脉高压症患者的PVP平均下降0.42kpa,其中4例下降幅度达0.49～0.69kpa。PVP的下降幅度与血清白蛋白浓度呈高度负相关(r=-0.76;P<0.05)。肝组织学检查发现,PVP下降幅度较大的患者其肝细胞变性坏死也较严重。对照组(非肝硬变患者)给予甲氰咪胍后PVP无明显变化。本文结果说明通过拮抗肝硬变时血中某些异常升高的液递物质,可以达到降低PVP的目的。

Some humoral substances ( such as histamine ) in blood increase in cir rhosis, and elevates the portal venous pressure ( PVP ) . This isa report on the effect of cimetidine, an antagonist of histamine, on the PVP in cirrhotic patients with portal hypertension. After a dose of 0.2g Cimetidine was given intravenously, an average lowering of 0.42kpa of PVP was observed in cirrhotic patients, and in 4 of them, the lowering of PVP attained 0.49?0.69kPa.The degree of lowering of PVP was correlated to the level of serum albumin ( r =-o.76; P<0.05) and the condition of hepatocellular degeneration and necrosis.The PVP in control group ( noncirrhotic patients ) had no significant change after giving Cimetidine. Our study suggests that the PVP can be reduced by using certain antagonists to some of the humoral substances which increase in cinrhosis and aggravate portal hypertersion.