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目的：比较普萘洛尔单用及与哌唑嗪联合应用降低门脉高压、预防食管静脉曲张破裂出血的疗效及安全性。方法：５３例肝硬化伴中度以上食管静脉曲张（内镜检查证实）的连续入院患者随机化分组后分别接受普萘洛尔联合哌唑嗪（试验组）或单用普萘洛尔（对照组）治疗，随访直至终点事件出现；治疗前和随访第３个月时行心肝核素显影比值（Ｈ／Ｌ）测定。结果：试验组（２７例）和对照组（２６例）的平均随访期为１３个月。用药后，试验组患者的Ｈ／Ｌ值显著下降（Ｐ＝０．０１）。对于有出血史的患者，试验组用药后Ｈ／Ｌ值明显下降（Ｐ＝０．０１），下降的绝对差值及相对比例均明显优于对照组（Ｐ＝０．０２）；试验组Ｈ／Ｌ值下降＞ ２０％的患者比例亦显著高于对照组（Ｐ＝０．０４）。两组患者的平均无出血时间无明显差异（Ｐ＝０．４２）；但Ｋａｐｌｅｎ－Ｍｅｉｅｒ曲线显示，在９０～２３７天左右，试验组患者的累积未出血率高于对照组（９０．５％比７１．３％）。１０例患者因药物不良反应而停药，其中试验组７例，对照组３例。结论：对于既往有出血史的患者，普萘洛尔与哌唑嗪联合应用在第３个月时可使门静脉压力较基础值明显下降；Ｈ／Ｌ的下降幅度和药物有效率均明显优于普萘洛尔单用，但不良反
Objective: To compare the efficacy and safety of propranolol alone and in combination with prazosin in reducing portal hypertension in preventing esophageal variceal bleeding. Methods: Fifty-three consecutive hospitalized patients with cirrhosis and moderate esophageal varices (confirmed by endoscopy) were randomized to receive propranolol combined with prazosin (experimental group) or propranolol alone Group), followed up until the end point occurred; before treatment and at the 3rd month of follow-up, the ratio of H / L development was measured. Results: The average follow-up period of the experimental group (27 cases) and the control group (26 cases) was 13 months. After treatment, the H / L values in the test group decreased significantly (P = 0.01). For patients with a history of bleeding, the H / L value of the experimental group decreased significantly (P = 0.01), the absolute difference between the two groups dropped significantly (P = 0.02) The proportion of patients with> 20% decrease in / L value was also significantly higher than that in control group (P = 0.04). There was no significant difference in mean bleeding-free time between the two groups (P = 0.42). However, Kaplen-Meier curves showed that the cumulative hemorrhage rate in the test group was higher than that in the control group (90.5% Than 71.3%). Ten patients discontinued due to adverse drug reactions, including 7 in the test group and 3 in the control group. CONCLUSION: Propranolol combined with prazosin can reduce the portal vein pressure more than the baseline value at the third month in patients with previous history of bleeding. The decrease in H / L and the drug-effective rate were significantly superior to those of prazosin Propranolol alone, but adverse reactions