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普萘洛尔与5-单硝酸异山梨醇酯联用对肝硬化门静脉血流动力学的影响 总被引:5,自引:0,他引:5
通过彩色多普勒超声显像仪观测普萘洛尔与5-单硝酸异山梨醇酯(ISMN)联用对肝硬化门静脉血流动力学的影响。19例乙型肝炎后肝硬化患者并有内镜证实的食管静脉曲张。治疗组ISMN 20mg,每日2次,普萘洛尔10mg~20mg,每日3次;对照组为健康受试者。采用同个体自身治疗前后对照研究。结果表明应用普萘洛尔与ISMN治疗1周后,Dpv、Vpv均显著性下降(P<0.01),Opv也显著性降低(711.76±515.52 vs 484.02±222.93)mL/min,P<0.01;Qsv显著性降低(558.07±354.62 vs 394.02±267.57)ml/min,P<0.01;但Qsmv的变化不明显(P>0.05)。治疗4周后也获得了同样的效果。普萘洛尔与ISMN联用可以降低Qpv和Qsv,具有预防上消化道出血的作用。 相似文献
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硝酸异山梨酯治疗心力衰竭的临床研究 总被引:7,自引:0,他引:7
硝酸异山梨酯通过较强地扩张小静脉及较弱地扩张小动脉,降低心脏的前后负荷,改善心力衰竭的血流动力学状态,从而缓解症状、提高射血分数和运动耐量,有益预后。本文就硝酸异山梨酯的治疗作用及临床的应用方案作一综述。 相似文献
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肝硬化患者门静脉系统血流动力学改变的彩色多普勒超声研究 总被引:10,自引:0,他引:10
目的观察肝硬化患者门静脉系统血流动力学的改变及其与肝功能Chil-Pugh分级、上消化道出血的关系.方法31例肝硬化患者于空腹静息状态下取仰卧位行彩色多普勒超声探查门静脉系统.结果肝硬化组的门静脉、脾静脉及肠系膜上静脉直径增宽,血流速度显著下降;脾静脉血流量(Qsv)显著高于正常对照组(748.90±382.16 ml/min vs 242.96±113.53 ml/min,P<0.01).肝硬化出血组脾静脉、肠系膜上静脉直径增宽、流速加快、血流量明显增多.Child-Pugh C级患者门静脉流速及门静脉血流量明显(Qpv)低于A级、B级.结论食管静脉曲张上消化道出血与脾静脉、肠系膜上静脉血流量显著增加、Qsv/Qpv比值增大密切相关;而门静脉流速及门静脉血流量随肝功能恶化而明显下降.因此,动态观测上述指标对判断门静脉高压上消化道出血的危险性及肝功能状况有重要临床意义. 相似文献
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目的探讨普萘洛尔联合5-单硝酸异山梨酯治疗对肝硬化门静脉高压患者血流动力学参数的影响。方法 30例肝功能Child-Pugh分级A、B级的肝硬化门静脉高压患者随机分为两组,其中普萘洛尔治疗组15例,普萘洛尔联合5-单硝酸异山梨酯治疗组15例,疗程均为48周。所有患者治疗前后均通过超声多普勒显像仪观察门静脉血流速度(VFP)和门静脉内径(PVD),并计算门静脉充血指数(PCI)。结果普萘洛尔组治疗前后VFP分别为(12.01±1.75)cm/s和(10.80±1.32)cm/s,PVD分别为(20.73±1.58)mm和(19.53±1.41)mm,差异均有统计学意义(P<0.05),PCI未显著下降(P>0.05);联合组治疗前VFP、PVD和PCI分别为(11.40±1.55)cm/s、(20.87±1.50)mm和(0.2940±0.4561),治疗后分别为(9.60±1.30)cm/s、(15.87±1.19)mm和(0.2107±0.4220),差异均有统计学意义(P均<0.05);两组比较治疗后的VFP、PVD和PCI差异均有统计学意义(P均<0.05)。结论普萘洛尔联合5-单硝酸异山梨酯较单用普萘洛尔能更有效地降低肝硬化门静脉高压血流动力学参数,具有预防上消化道出血的作用。 相似文献
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本文通过彩色多普勒超声技术,检测肝硬化门静脉(pv)、脾静脉(sv)血流情况,探讨肝硬化患者门静脉系统血流动力学变化。 相似文献
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硝酸异山梨酯对高血压患者脉压的影响 总被引:1,自引:0,他引:1
脉压是动脉扩张性的一个指标 ,但治疗缩小脉压的药物的临床研究 ,国内少见报道。1998年 4月~ 2 0 0 0年 4月 ,我院收治 30 0例原发性高血压患者 ,脉压 >6 0 mm Hg(1mm Hg≈0 .133k Pa) ,经硝酸异山梨酯 (ISDN)临床治疗观察 ,效果良好。报告如下。一般资料 :取同期 30 0例原发性高血压患者 ,男 2 2 0例 ,女 80例 ,年龄 5 5~ 84岁。根据 1999年 WHO高血压诊断标准 ,符合 1级 30例 ,2~ 3级 2 70例。随机分为硝酸异山梨酯组 (2 0 0例 )与对照组 (10 0例 )。给药剂量和方法 :入选前停用一切降压药物 ,硝酸异山梨酯组从小剂量 (5~ 10 mg)… 相似文献
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静滴硝酸异山梨酯对心绞痛患者血液动力学影响及临床价值 总被引:8,自引:0,他引:8
研究选择冠心病稳定型心绞痛患者26例,分别以80μg/min和160μg/min的剂量静脉滴注硝酸异山梨酯(ISDN)30分钟,经左心导管测定血液动力学参数。结果显示80μg/min组用药前后(15分钟)仅左室舒张末压明显下降,而160μg/min较大剂量组除发现左室舒张末压显著降低外,主动脉收缩压、主动脉平均压的降低也达到统计学意义,两组治疗前后的心率、主动脉舒张压、左室收缩压最大上升速度均无显著变化,提示160μg/min较大剂量静滴ISDN不仅能降低容量负荷,还可使动脉系统压力下降。左心室灌注压升高,左室舒张末压和心容积减少、收缩期射血分布到室壁力量减弱均可降低心肌耗氧量,改善心肌缺血。 相似文献
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目的探讨非洛地平缓释片和心得安联合应用对肝硬化门脉高压的治疗作用.方法69例肝硬化门脉高压患者随机分为非洛地平组、心得安组和联合用药组,以多普勒超声检测三组患者治疗前、后门脉血流动力学的变化.结果治疗4周后,联用组门脉流速、流量及脾静脉内径、流速、流量均较治疗前有明显减少.门脉流速、流量、脾静脉血流量的减少联用组较其他两组明显(P<0.05),此外脾静脉内径、血流速度联用组还较心得安组明显减少(P<0.05).三组患者治疗后平均动脉压无显著下降.结论非洛地平缓释片和心得安联合应用较单一应用具有更好的降低肝硬化患者门脉压力的作用. 相似文献
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目的通过经颅多普勒超声动态评价立普妥对脑梗死患者脑血流动力学的影响。方法通过经颅多普勒超声检查100例首次急性脑梗死住院患者的脑血流动力学,根据是否规律服用立普妥分为:服药组53例和未服药组47例。发病3个月后再次随访经颅多普勒超声。结果与发病1周内比较,服药组患者发病3个月后大脑中动脉血流速度明显增快,搏动指数明显下降(P0.05);未服药组患者发病3个月后双侧大脑中动脉血流速度和搏动指数差异无统计学意义(P0.05)。结论立普妥对改善脑梗死脑血流动力学有一定作用。 相似文献
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Qin Chengyong Liu Dongxing Zhu Juren Fu Lina Wan Zhaohai Zhang Guoquan Jia Tao 《Journal of digestive diseases》2001,2(1):34-37
OBJECTIVE : To evaluate the therapeutic effect of release‐controlled nifedipine on portal hypertension. METHODS : Thirty‐two cirrhotic patients were enrolled to investigate, by using duplex Doppler ultrasonography, differences in portal hemodynamics before and after treatment with release‐controlled nifedipine (30 mg once per day). RESULTS : After taking nifedipine, the diameter, blood velocity and blood flow of the portal vein decreased, but only the change in velocity was statistically significant. After treatment, the congestion index increased, and the blood velocity and blood flow of the splenic vein significantly decreased. The resistance and pulsatile indices of the right hepatic and splenic arteries also decreased markedly. The total hepatic blood flow was elevated slightly and there were no significant changes in mean arterial pressure and heart rate. CONCLUSIONS : The resistance and pulsatile indices of the hepatic and splenic arteries are representative indices of portal resistance. Release‐controlled nifedipine may decrease portal pressure by the following mechanisms: (i) decrease of systemic blood pressure triggers the sympathetic reflex, leading to splanchnic artery constriction and portal blood flow reduction; (ii) dilatation of the portal vein and sinusoids leads to decrease portal resistance; and (iii) dilatation of the collateral veins. Nifedipine has no significant effect on systemic circulation in normotensive cirrhotic patients, therefore it has good prospects as a drug for clinical use in portal hypertension. 相似文献
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肝硬化患者门脉系统血流动力学指标与Child-Pugh分级的相关性研究 总被引:2,自引:0,他引:2
研究肝硬化患者脾静脉和门静脉血流量及其比值(Qsv/QPv)与肝脏储备功能Child-Pugh分级的关系.采用彩色多普勒超声仪对168例肝炎后肝硬化患者(ChildA级43例,B级67例,C级58例)和59例健康成年人检测了门静脉、脾静脉的内径、流速,再计算出相关的血流量,并进行了比较分析.结果显示,随着Qsv/Qpv的升高,肝硬化患者的肝功能不断下降,各组之间比较有非常显著性差异(P<0.01).肝硬化患者肝功能损害越重,脾静脉血流量占门静脉血流量的比值越高.如果将Qsv/Qpv的截断值定于40%,则其提示肝硬化患者肝功能下降至B级或以下的敏感性、特异性、准确性分别达80.80%、74.42%和79.17%.彩色多普勒超声测量门静脉系统及其血流动力学指标用于判断肝硬化患者的肝功能状态是一个较好的临床手段. 相似文献
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Endoscopic ultrasonographic evaluation of hemodynamics related to variceal relapse in esophageal variceal patients 总被引:1,自引:0,他引:1
Takahiro Sato Katsu Yamazaki Jouji Toyota Yoshiyasu Karino Takumi Ohmura Jun Akaike 《Hepatology research》2009,39(2):126-133
Aim: To evaluate retrospectively the hemodynamics of esophageal varices before and after endoscopic injection sclerotherapy (EIS) using endoscopic color Doppler ultrasonography (ECDUS).
Methods: The study included 306 patients whose esophageal varices had been treated with EIS. The underlying pathologies of portal hypertension in these 306 patients included liver cirrhosis (193), cirrhosis associated with hepatocellular carcinoma (102), primary biliary cirrhosis (6), idiopathic portal hypertension (4) and extrahepatic portal vein obstruction (1). ECDUS was used for the examination of all 306 cases before EIS and 3–5 months after EIS. ECDUS was performed to evaluate flow in the left gastric vein, paraesophageal veins, perforating veins and cardiac intramural veins.
Results: The patients were divided into three groups according to time of esophageal variceal recurrence: early recurrence within one year (Group A, n = 16), no recurrence over three years (Group B, n = 12), and recurrence between one and three years (Group C, n = 278). Before EIS, the frequency of detection of perforating veins and the inflowing type of perforating veins using ECDUS was significantly higher for Group A than Groups B or C. After EIS, the frequency of detection of cardiac intramural veins, perforating veins and the inflowing type of perforating veins using ECDUS was significantly higher in Group A than Groups B or C.
Conclusion: Endoscopic ultrasonographic evaluation of the hemodynamics in esophageal varices before and after EIS enables prediction of early variceal recurrence. 相似文献
Methods: The study included 306 patients whose esophageal varices had been treated with EIS. The underlying pathologies of portal hypertension in these 306 patients included liver cirrhosis (193), cirrhosis associated with hepatocellular carcinoma (102), primary biliary cirrhosis (6), idiopathic portal hypertension (4) and extrahepatic portal vein obstruction (1). ECDUS was used for the examination of all 306 cases before EIS and 3–5 months after EIS. ECDUS was performed to evaluate flow in the left gastric vein, paraesophageal veins, perforating veins and cardiac intramural veins.
Results: The patients were divided into three groups according to time of esophageal variceal recurrence: early recurrence within one year (Group A, n = 16), no recurrence over three years (Group B, n = 12), and recurrence between one and three years (Group C, n = 278). Before EIS, the frequency of detection of perforating veins and the inflowing type of perforating veins using ECDUS was significantly higher for Group A than Groups B or C. After EIS, the frequency of detection of cardiac intramural veins, perforating veins and the inflowing type of perforating veins using ECDUS was significantly higher in Group A than Groups B or C.
Conclusion: Endoscopic ultrasonographic evaluation of the hemodynamics in esophageal varices before and after EIS enables prediction of early variceal recurrence. 相似文献
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目的 探讨糖尿病患者肾内动脉血流参数变化的临床意义。方法 将 64例糖尿病肾病患者按 2 4小时尿白蛋白排泄率 ( UAE)分为三组 ,采用美国 Acuson-As Pen彩色多谱勒能量图 ( CDEI) ,检测其肾内动脉血流分布情况及相关参数。结果 1组 ( 3 0例 ;UAE<10 ug/ min,运动后升高 )段间动脉收缩期峰值血流速度( Vm ax)、舒张末期血流速度 ( Vmi)、阻力指数 ( RI)与正常对照组 ( 3 0例健康人 )比较 ,均无显著性差异( P>0 .0 5) ;2组 ( 2 5例 ,UAE15~ 2 0 ug/ min)和 3组 ( 9例 ,UAE>2 0 0 ug/ min)以上各参数均明显高于对照组 ( P<0 .0 1) ,随肾损害程度的加重 ,肾彩色血流显像逐渐减少 ,阻力指数 ( RI)及脉动指数 ( PI)增高。结论 肾动脉血流参数为判断糖尿病肾病血管损害程度的主要依据 相似文献
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超声心动图对不同频率AAI及VVI起搏的血流动力学研究 总被引:9,自引:0,他引:9
目的本研究的目的在于评价不同频率AAI及VVI起搏的血流动力学效果,探索最佳起搏频率范围,比较AAI及VVI起搏的血流动力学效果。方法37例植入永久心脏起搏器的患者分为两组,AAI组17例,VVI组20例。程控起搏频率从50~100次/分,以超声心动图评价其血流动力学效果。结果在AAI起搏组,70次/分起搏的心排血量(CO)高于50及60次/分起搏(P<0.05)。80~90次/分起搏的CO变化无显著性差异。100次/分起搏的CO低于90次/分起搏。在VVI起搏组,起搏频率超过80次/分时,CO不再增高,110次/分起搏的CO甚至低于70次/分起搏,左室射血分数(LVEF)则随之下降。但AAI起搏的CO及LVEF在起搏频率相同情况下显著高于VVI起搏组。结论在有心脏病的患者,最佳起搏频率范围较窄,为70~80次/分。AAI起搏的血流动力学效果显著优于VVI起搏。 相似文献
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硝苯地平控释片对肝硬化患者门脉血流动力学影响的双功多普勒观察 总被引:5,自引:0,他引:5
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32例肝硬化门脉高压患者在用硝苯地平控释片30mg1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 相似文献