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目的 研究硝苯地平控释片对门脉高压的治疗作用。方法 以双功多普勒技术检测了3 2例肝硬化门脉高压患者在用硝苯地平控释片 3 0mg 1次 /d前后门脉血流动力学的变化。 结果 用药后门静脉流速降低 ,充血指数上升 ;脾静脉流速、流量降低 ;肝动脉、脾动脉的阻力指数及脉动指数降低 ;肝总血流量增加 ;平均动脉压及心率无显著变化。结论 肝、脾动脉的阻力指数及搏动指数是门脉阻力的良好指标。硝苯地平控释片可通过如下机制降低门脉压 :①降低全身血压引起交感神经反射使内脏动脉收缩 ,门脉血流减少 ;②扩张门脉及肝窦 ,降低门脉阻力 ;③扩张侧支循环。该药对血压正常的肝硬化患者的平均动脉压无显著影响 ,有良好的应用前景。
Objective To study the therapeutic effect of nifedipine GITS on portal hypertension. Methods The changes of portal hemodynamics in 32 patients with cirrhosis and portal hypertension before and after treatment with nifedipine GITS 30 mg once daily were detected by dual-Doppler technique. Results After administration, the portal vein velocity decreased and the congestion index increased. The splenic venous flow velocity and flow rate decreased. The resistance index and pulsatility index of hepatic artery and splenic artery decreased. The total hepatic blood flow increased. The mean arterial pressure and heart rate had no significant changes. Conclusion The resistance index and pulsatility index of liver and splenic artery are good indicators of portal resistance. Nifedipine controlled release tablets can reduce portal pressure through the following mechanisms: ① reduce systemic blood pressure caused by sympathetic reflex visceral artery contraction, reduced portal blood flow; ② dilatation of the portal and hepatic sinusoids to reduce portal resistance; ③ dilatation Branch cycle. The drug has no significant effect on mean arterial pressure of patients with normal blood pressure and has good application prospect.