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本研究旨在观察(a)酒糟性肝硬化病人持续口服可乐定能否引起门脉压力有效与持续降低,(b)治疗对肝功能的影响。病人和方法:15例酒精性肝硬化病人(男14例,女1例),平均年龄52岁。均经内镜检查有食管静脉曲张。属于PughA级2例,B级8例,C级5例。5例有食管静脉曲张出血史。病人禁食一夜后,经颈静脉插管测心肺压力和心输出量,再测肝静脉契压(WHVP)和游离肝静脉压(FHVP)之梯度[肝静脉压梯度(HVPG)]。然后口服可乐定,每天2次,开始剂量为0.075mg/d,每日增加0.075mg,直到剂量达到0.30～0.45mg/d。达最大剂量64±10d后重复检查。结果:长期服用可乐定可使HVPG显著下降,这是由于FHVP显著增加所致,因为WHVP无明显改变。15例中10例(67%)HVPG下降超快基线值10%。有无食管静脉出血史者的平均HVPG降低无统计学意义。可乐定可下降动脉压,减慢心率,同时减少心输出量,但周身血管阻力无明显改变。可乐定可增加心肺压、右心房压、肺动脉和肺毛细血管压。半乳糖排
This study aimed to observe (a) whether continuous oral clonidine in patients with LSD caused effective and sustained reductions in portal pressure, and (b) the effect of treatment on liver function. Patients and Methods: 15 patients with alcoholic cirrhosis (14 males and 1 female) with an average age of 52 years. Esophageal varices were detected by endoscopy. Belong to PughA grade 2 cases, B grade in 8 cases, C grade in 5 cases. 5 cases had history of esophageal variceal bleeding. After the patient was fasted overnight, the pulmonary pressure and cardiac output were measured via the jugular vein and the gradient of hepatic venous pressure (WHVP) and free hepatic venous pressure (FHVP) [hepatic venous pressure gradient (HVPG)] was measured. Then oral clonidine 2 times a day, starting dose of 0.075mg / d, 0.075mg daily increase until the dose reached 0.30 ~ 0.45mg / d. Up to a maximum dose of 64 ± 10d after repeated examination. RESULTS: Long-term clonidine administration significantly reduced HVPG due to a significant increase in FHVP because there was no significant change in WHVP. In 15 cases, HVPG decreased 10% (10%) in 10 patients (67%). The average HVPG reduction in patients with or without esophageal variceal bleeding was not statistically significant. Clonidine decreased arterial pressure, heart rate, and reduce cardiac output, but no significant changes in systemic vascular resistance. Clonidine can increase cardiorespiratory pressure, right atrial pressure, pulmonary artery and pulmonary capillary pressure. Galactose row