摘要
目的比较阿罗洛尔与普萘洛尔在肝硬化门静脉高压症患者中的疗效。方法采用前瞻性对照研究设计,纳入2021年1月至2024年10月新乡市中心医院收治的86例肝硬化门静脉高压症患者作为试验对象,按随机数字表法将其分为两组,分别给予阿罗洛尔(阿罗洛尔组,n=43)与普萘洛尔(普萘洛尔组,n=43)进行治疗,观察两组治疗后门静脉流速、肝静脉减震指数、一氧化氮、内皮素1、血管生成素2、血管内皮生长因子、可溶性分化抗原163、白细胞介素6、丙氨酸氨基转移酶、天冬氨酸氨基转移酶水平变化及治疗安全性、消化道出血率。结果阿罗洛尔组门静脉流速为(18.71±3.51)cm/s,高于普萘洛尔组的(15.78±3.66)cm/s(t=3.789,P<0.05);阿罗洛尔组肝静脉减震指数为(0.60±0.08),低于普萘洛尔组的(0.66±0.11)(t=2.627,P<0.05);阿罗洛尔组一氧化氮水平为(79.74±11.11)μmol/L,高于普萘洛尔组的(74.55±10.21)μmol/L(t=2.254,P<0.05);阿罗洛尔组内皮素1水平为(58.10±9.16)pg/mL,低于普萘洛尔组的(63.67±9.27)pg/mL(t=2.803,P<0.05);阿罗洛尔组与普萘洛尔组血管生成素2、血管内皮生长因子水平比较,差异无统计学意义(t=1.745、1.523,均P>0.05);阿罗洛尔组可溶性分化抗原163、白细胞介素6水平[分别为(2.01±0.41)ng/mL、(30.57±8.23)pg/mL]均低于普萘洛尔组[分别为(2.33±0.40)ng/mL、(35.42±10.61)pg/mL,t=3.622、2.370,均P<0.05],阿罗洛尔组丙氨酸氨基转移酶、天冬氨酸氨基转移酶水平[分别为(66.32±9.02)U/L、(65.09±8.40)U/L]与普萘洛尔组[分别为(67.55±8.65)U/L、(66.69±11.09)U/L]比较,差异无统计学意义(t=0.646、0.752,均P>0.05);阿罗洛尔组与普萘洛尔组治疗安全性(13.95%vs 18.60%)及消化道出血率(9.30%vs 16.28%)比较,差异无统计学意义(χ^(2)=0.341、0.938,均P>0.05)。结论阿罗洛尔与普萘洛尔治疗肝硬化门静脉高压症均能改善门静脉血流动力学、血管内皮功能,抑制炎症水平,但阿罗洛尔在改善门静脉血流动力学、血管内皮功能方面更具优势。
Objective To compare the application effect of arotinolol and propranolol on patients with cirrhotic portal hypertension.Methods A prospective controlled study design was adopted.A total of 86 patients with cirrhotic portal hypertension admitted to the Xinxiang Central Hospital from January 2021 to October 2024 were selected as test subjects and divided into two groups according to the random number table method.The two groups were treated with arotinolol(the arotinolol group,n=43)and propranolol(the propranolol group,n=43),respectively.The changes of portal vein flow velocity,hepatic vein damping index,nitric oxide,endothelin-1,angiopoietin-2,vascular endothelial growth factor,soluble cluster of differentiation 163,interleukin-6,alanine aminotransferase and aspartate aminotransferase,as well as treatment safety and the rate of gastrointestinal bleeding were observed in the two groups after treatment.Results The portal vein flow velocity in the arotinolol group was(18.71±3.51)cm/s,higher than(15.78±3.66)cm/s in the propranolol group(t=3.789,P<0.05),while the hepatic vein damping index was(0.60±0.08)in the arotinolol group,lower than(0.66±0.11)in the propranolol group(t=2.627,P<0.05).The level of nitric oxide was(79.74±11.11)μmol/L in the arotinolol group,higher than(74.55±10.21)μmol/L in the propranolol group(t=2.254,P<0.05),while the level of endothelin-1 was(58.10±9.16)pg/mL in the arotinolol group,lower than(63.67±9.27)pg/mL in the propranolol group(t=2.803,P<0.05).There were no statistically significant differences in the levels of angiopoietin-2 and vascular endothelial growth factor between the two groups(t=1.745,1.523,both P>0.05).The levels of soluble cluster of differentiation 163 and interleukin-6 in the arotinolol group were(2.01±0.41)ng/mL and(30.57±8.23)pg/mL,lower than(2.33±0.40)ng/mL and(35.42±10.61)pg/mL in the propranolol group(t=3.622,2.370,both P<0.05).The levels of alanine aminotransferase and aspartate aminotransferase were(66.32±9.02)and(65.09±8.40)U/L in the arotinolol group,which were not statistically different from(67.55±8.65)and(66.69±11.09)U/L in the propranolol group(t=0.646,0.752,both P>0.05).There were no statistically significant differences in treatment safety(13.95%vs 18.60%)and the rates of gastrointestinal bleeding(9.30%vs 16.28%)between the arotinolol group and the propranolol group(χ^(2)=0.341,0.938,both P>0.05).Conclusion Both arotinolol and propranolol can improve portal vein hemodynamics and vascular endothelial function,and inhibit inflammation in patients with cirrhotic portal hypertension.However,arotinolol demonstrates superior efficacy in enhancing portal vein hemodynamics and vascular endothelial function.
作者
郭皓
李艳茹
段花玲
李辰
毛建娜
王云溪
GUO Hao;LI Yanru;DUAN Hualing;LI Chen;MAO Jianna;WANG Yunxi(Department of Gastroenterology,Xinxiang Central Hospital,Xinxiang 453000,China;Department of Cardiovascular Medicine,Xinxiang Central Hospital,Xinxiang 453000,China;The Fourth Clinical College of Xinxiang Medical University,Xinxiang 453000,China)
出处
《中国药物应用与监测》
2026年第2期252-256,共5页
Chinese Journal of Drug Application and Monitoring
基金
2023年度河南省医学科技攻关计划联合共建项目(LHGJ20230886)。
