RELATION BETWEEN PORTAL PRESSURE RESPONSE TO PHARMACOTHERAPY AND RISK OF RECURRENT VARICEAL HEMORRHAGE IN PATIENTS WITH CIRRHOSIS
RELATION BETWEEN PORTAL PRESSURE RESPONSE TO PHARMACOTHERAPY AND RISK OF RECURRENT VARICEAL HEMORRHAGE IN PATIENTS WITH CIRRHOSIS
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DOI：
10.1016/s0140-6736(95)91740-3
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发表时间：
1995-10-21
期刊：
影响因子：
168.9
通讯作者：
RODES, J
中科院分区：
文献类型：
--
作者：
FEU, F;GARCIAPAGAN, JC;RODES, J
在有静脉曲张破裂出血的患者中，心得安治疗可降低静脉曲张破裂出血复发的风险。然而，门静脉压力对药物治疗的反应和临床事件之间的关系还没有很好的确定。对69名在静脉曲张破裂出血后继续接受心得安治疗的肝硬变患者进行了前瞻性研究。在持续用药前和用药3个月时测量肝静脉压力梯度(HVPG)，其中25例在用药3个月时肝静脉压差下降20%或以上。在28(SD 17)个月的随访期间，这25名患者中有2名患者发生了再出血，而44名患者中有23名患者的HVPG减少较少。1、2和3年再出血的累积概率在HVPG下降大于或等于20%的患者中分别为4%、9%和9%，在HVPG下降的患者中分别为28%、39%和66%
In patients with variceal bleeding as a complication of hepatic cirrhosis, propranolol therapy reduces the risk of recurrent variceal haemorrhage. However, the relation between portal pressure response to pharmacological treatment and clinical events has not been well defined. This relation was prospectively investigated in 69 cirrhotic patients receiving continued propranolol therapy after an episode of variceal bleeding. Hepatic venous pressure gradient (HVPG) was measured before and at 3 months of continued drug therapy.At 3 months HVPG had fallen by 20% or more in 25 patients. During follow-up of 28 (SD 17) months rebleeding occurred in 2 of these 25 patients compared with 23 of 44 who had lesser reductions in HVPG. Cumulative probability of rebleeding at 1, 2, and 3 years was 4%, 9%, and 9% in patients with a decrease in HVPG greater than or equal to 20%,and 28%, 39%, and 66% in patients with a decrease in HVPG