[Use of calcium-channel blockers in cirrhotic patients with portal hypertension].
Four calcium-channel blockers (CCB)-nifedipine (NIF), verapamil (VER), cinnarizine (CIN) and tetrandrine (TET)-are currently available and widely used at home and abroad for the treatment of cardiovascular diseases. To confirm any effects of CCBs on cirrhotic patients with portal hypertension, the esophageal variceal pressure (EVP) during routine gastroscopy, hemodynamic study, portal venous pressure and rebleeding rate of esophageal varices after 18 months were measured and compared in 321 patients from 23 hospital. The results demonstrated that the CCBs could significantly reduce the EVP, portal venous pressure and the portal blood flow in cirrhotic patients with portal hypertension. Furthermore, we found that neither heart rates nor blood pressure showed any significant change in spite of pressures and flow reduction. The proportion of patients free of recurrent gastrointestinal bleeding 18 months after inclusion in this study was 87.9% in the TET group, which was much higher than in the other 4 groups (p less than 0.05). The results of this study suggest that TET seems to be more appropriate for cirrhotic patients with portal hypertension at the present time.
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D000293:Adolescent; D000328:Adult; D000368:Aged; D000470:Alkaloids / Q000627:therapeutic use*; D000818:Animals; D044182:Benzylisoquinolines; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D002936:Cinnarizine / Q000627:therapeutic use; D004947:Esophagus / Q000098:blood supply; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000188:drug therapy*; D066298:In Vitro Techniques; D008103:Liver Cirrhosis / Q000188:drug therapy*; D008106:Liver Cirrhosis, Experimental / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000627:therapeutic use; D011169:Portal Vein / Q000187:drug effects; D051381:Rats; D011919:Rats, Inbred Strains; D014680:Veins; D014690:Venous Pressure; D014700:Verapamil / Q000627:therapeutic use
D000470:Alkaloids; D044182:Benzylisoquinolines; D002121:Calcium Channel Blockers; C009438:tetrandrine; D002936:Cinnarizine; D014700:Verapamil; D009543:Nifedipine