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在肝硬化病人,心得安能有效地预防复发性胃肠出血。然而,心得安降低心排出量及肾素释放量,可能从而减少肾血流,导致肾功能恶化。为探讨此问题,作者给13例经组织学证实的肝硬化,伴食管静脉曲张破裂,出血已完全停止2周以上的患者口服心得安。治疗前及给心得安40mg口服后1小时(急性给药),或者在连续服用心得安使心率降低25%后1个月(慢性给药,10例),分别测定全身和内脏血液动力学、肾素-醛固酮系统及肾功能。平均每天心得安剂量为186±106mg(均值±标准差)。患者均无明显腹水、黄疸或肝性脑病。
In patients with cirrhosis, propranolol can effectively prevent recurrent gastrointestinal bleeding. However, propranolol can reduce cardiac output and renin release, which may reduce renal blood flow, leading to deterioration of renal function. To explore this issue, the authors gave oral safety to 13 patients with histologically confirmed cirrhosis, ruptured esophageal varices, and bleeding that had stopped completely for more than two weeks. One hour after treatment with 40 mg of propranolol (acute administration) or one month after chronic heart failure (chronic administration, 10 cases), the systemic and visceral hemodynamics, Renin - aldosterone system and renal function. The average daily dose of propranolol is 186 ± 106 mg (mean ± standard deviation). Patients had no significant ascites, jaundice or hepatic encephalopathy.