关键词: 肝硬化, 食管胃底静脉曲张, 普萘洛尔, 血流动力学

Abstract: Objective To study the hemodynamic response and clinical characteristics of patients with esophageal and gastric varices after the intervention of propranolol.Methods There were 102 cirrhotic patients with esophagogastric varices in our hospital undergoing the measurement of hepatic vein pressure gradient before and 7 days after the administration of propranolol.The patients who successfully completed the 2 tests were followed up to analyze the tolerance of propranolol,hemodynamic status and bleeding.Results There were 96 of 102 patients finally included in the study,and the hemodynamic response rate accounted for 43.75%.In responders,the heart rate,wedged hepatic venous pressure and hepatic venous pressure gradient after short-term administration of propranolol were significantly lower than those before administration (P<0.05).In non-responders,the heart rate and hepatic venous pressure gradient after administration were significantly lower than those before administration (P<0.05).The post-treatment hepatic vein pressure gradient of the responders was significantly lower than that of the non-responders (P<0.05).During the follow-up of 3 years,the incidence of esophageal and gastric variceal bleeding in the whole cohort was 25.00%.The incidence of bleeding in responders was 0,significantly lower than 55.56% in non-responders (P<0.05).Conclusion Patients with cirrhotic esophagogastric varices who received propranolol for a short period of time were probable to have a hemodynamic response.And those with no hemodynamics response had a higher risk of bleeding than responders.

Key words: Liver cirrhosis, Esophageal and gastric varices, Propranolol, Hemodynamics