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目的观察丹参酮ⅡA磺酸钠注射液治疗门脉高压症合并食管静脉曲张的临床疗效及其对血管紧张素Ⅱ、血流动力学的影响。方法 120例门脉高压症合并食管静脉曲张破裂出血的患者随机分为试验组和对照组,各60例。试验组静脉滴注丹参酮ⅡA磺酸钠注射液40~80 mg·d~(-1),5%葡萄糖注射液或0.9%氯化钠注射液250~500 mL稀释,每天1次;对照组静脉滴注奥曲肽100μg,再以25μg·L~(-1)持续静脉滴注,维持1~3 d。2组均治疗14 d。比较2组治疗后的临床疗效、血管紧张素Ⅱ、血流动力学变化和不良反应发生情况。结果治疗后,试验组总有效率为86.67%,显著高于对照组的58.34%(P<0.05)。治疗后,试验组血管紧张素Ⅱ、门静脉主干和脾静脉的内径、血流速度、血流量均显著降低(P<0.05);试验组显著低于对照组(P<0.05)。试验组不良反应发生率为3.33%(2/60),对照组不良反应发生率为10.00%(6/60,P<0.05)。结论丹参酮ⅡA磺酸钠对门脉高压症合并食管静脉曲张有一定的临床疗效,不良反应发生率低。
Objective To observe the clinical efficacy of sodium tanshinone Ⅱ A sulfonate injection in the treatment of portal hypertension combined with esophageal varices and its effect on angiotensin Ⅱ and hemodynamics. Methods A total of 120 patients with portal hypertension complicated with esophageal variceal bleeding were randomly divided into test group and control group, with 60 cases each. The test group was intravenously dripped with sodium tanshinone Ⅱ A sulfonate 40 ~ 80 mg · d -1, diluted with 250 ~ 500 mL 5% dextrose injection or 0.9% sodium chloride injection once daily, Instillation of octreotide 100μg, then 25μg · L ~ (-1) continuous intravenous infusion for 1 ~ 3 d. Both groups were treated for 14 days. The clinical effects, angiotensin Ⅱ, hemodynamic changes and adverse reactions in the two groups were compared. Results After treatment, the total effective rate of the experimental group was 86.67%, which was significantly higher than that of the control group (58.34%, P <0.05). After treatment, the experimental group of angiotensin Ⅱ, portal vein and splenic vein diameter, blood flow velocity, blood flow were significantly reduced (P <0.05); experimental group was significantly lower than the control group (P <0.05). The incidence of adverse reactions in the experimental group was 3.33% (2/60), and the incidence of adverse reactions in the control group was 10.00% (6/60, P <0.05). Conclusion Tanshinone Ⅱ A sulfonate has clinical effect on portal hypertension complicated with esophageal varices, with a low incidence of adverse reactions.