国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2012年
11期
1604-1607
,共4页
普萘洛尔%门静脉高压%消化道出血%B型尿钠肽前体
普萘洛爾%門靜脈高壓%消化道齣血%B型尿鈉肽前體
보내락이%문정맥고압%소화도출혈%B형뇨납태전체
Propranolol%Portal hypertension%Gastrointestinal bleeding%Type-B natriuretic peptide precursors
目的 观察普萘洛尔治疗肝硬化门脉高压性消化道出血患者血浆B型尿钠肽前体(pro-BNP)水平.方法 随机将患者分为治疗组22例和对照组21例；治疗组给予普萘洛尔10 mg口服,每天3次；对照组不用普萘洛尔治疗,输血、抑酸等治疗相同.测定两组患者出血前和出血后以及治疗后24h、1周、2周、4周、8周B型尿钠肽前体水平.结果 治疗组和对照组患者血浆pro-BNP水平在消化道出血前明显高于消化道出血后(P＜0.01)；普萘洛尔治疗后血浆pro-BNP水平降低(P＜ 0.05),2个月内再次出血发生率减低(P＜0.05),对照组血浆pro-BNP水平升高,2个月内出血发生率增加(P＜0.05).结论 普萘洛尔治疗可降低肝硬化患者血浆pro-BNP水平,延长再出血时间和减低再次出血发生率,pro-BNP水平与有效循环血容量相关,血浆pro-BNP水平可视为门脉高压性消化道出血独立预测因素.
目的 觀察普萘洛爾治療肝硬化門脈高壓性消化道齣血患者血漿B型尿鈉肽前體(pro-BNP)水平.方法 隨機將患者分為治療組22例和對照組21例；治療組給予普萘洛爾10 mg口服,每天3次；對照組不用普萘洛爾治療,輸血、抑痠等治療相同.測定兩組患者齣血前和齣血後以及治療後24h、1週、2週、4週、8週B型尿鈉肽前體水平.結果 治療組和對照組患者血漿pro-BNP水平在消化道齣血前明顯高于消化道齣血後(P＜0.01)；普萘洛爾治療後血漿pro-BNP水平降低(P＜ 0.05),2箇月內再次齣血髮生率減低(P＜0.05),對照組血漿pro-BNP水平升高,2箇月內齣血髮生率增加(P＜0.05).結論 普萘洛爾治療可降低肝硬化患者血漿pro-BNP水平,延長再齣血時間和減低再次齣血髮生率,pro-BNP水平與有效循環血容量相關,血漿pro-BNP水平可視為門脈高壓性消化道齣血獨立預測因素.
목적 관찰보내락이치료간경화문맥고압성소화도출혈환자혈장B형뇨납태전체(pro-BNP)수평.방법 수궤장환자분위치료조22례화대조조21례；치료조급여보내락이10 mg구복,매천3차；대조조불용보내락이치료,수혈、억산등치료상동.측정량조환자출혈전화출혈후이급치료후24h、1주、2주、4주、8주B형뇨납태전체수평.결과 치료조화대조조환자혈장pro-BNP수평재소화도출혈전명현고우소화도출혈후(P＜0.01)；보내락이치료후혈장pro-BNP수평강저(P＜ 0.05),2개월내재차출혈발생솔감저(P＜0.05),대조조혈장pro-BNP수평승고,2개월내출혈발생솔증가(P＜0.05).결론 보내락이치료가강저간경화환자혈장pro-BNP수평,연장재출혈시간화감저재차출혈발생솔,pro-BNP수평여유효순배혈용량상관,혈장pro-BNP수평가시위문맥고압성소화도출혈독립예측인소.
Objective To detect the plasma levels oftype-B natriuretic peptide precursors ( proBNP ) in patients with gastrointestinal bleeding due to liver cirrhosis portal hypertension and who received propranolol therapy.Methods The patients were randomly assigned to receive oral propranolol of 10 mg three times daily plus blood transfusion and acid suppression therap ( study group,22 patients ),or blood transfusion and acid suppression therap alone ( control group,21 patients ).proBNP levels were detected before and 24h and 1,2,4,and 8 weeks after bleeding in both groups.Results proBNP levels were markedly higher in both groups after gastrointestinal bleeding ( P ＜ 0.01 ).After propranolol treatment,proBNP levels declined ( P＜ 0.05 ) and the rate of repeated bleeding was lowered within two months ( P ＜ 0.05 ).Conclusions Propranolol therapy can reduce plasma levels ofproBNP in patients with cirrhosis,prolong time to repeated bleeding,and lower the incidence rate of repeated bleeding.proBNP level is associated with the blood volume of circulation and it can be seen as an independent predictor for gastrointestinal bleeding due to portal hypertension.
