Portal Hypertension Medication Effect Assessment And Related Gas Molecule Research

Objectives:Ultrasound positioning direct measurement of cirrhosis portal vein pressure under the physiological condition, to observe the propranolol, isosorbide mononitrate, alone or in conjunction In the treatment of the effect of portal hypertension. And compare the portal, and peripheral blood H2S, NO, CO in the content change.Material and Methods:1. Research objectThis subject will collect cirrhosis portal hypertension patients 15 cases 30 cases, male, female in 15 patients, patients were not occurring more than a gastrointestinal bleeding and not do esophageal stomach bottom vein intraoperative influence. Cirrhosis portal hypertension treatment diagnostic criteria and seventh edition textbooks are based on internal enacted in chapter 14 "cirrhosis of the standards.2.Give medicine methodBefore and after the treatment by their individual controlled study. Give medicine methods: patients were randomly divided into three groups, namely propranolol group, isosorbide mononitrate group, and combined treatment group. Propranolol group of initial measurement of 10mg, three times a day for oral, such as patients, not reduce heart rate increase gradually measurement 25% until requirements. Isosorbide mononitrate group of the initial measurement 30mg, one day twice for oral, If patients experienced difficult to tolerate headache gives 30mg a day once orally, combined treatment group give propranolol 10mg (three times daily oral), plus isosorbide mononitrate 30mg (twice daily oral).3. Pressure measuring methodThe test used ultrasound-guided percutaneous puncture by hepatoportal pressure measuring method of portal vein pressure measurement. And pressure measuring process in patients with venous return door.4.Measuring gas molecules in plasmaAdopt double antibody clip method measuring portal, and peripheral blood NO, CO, H2S in the content.Results:1 Cases collectedThe above 30 patients center isosorbide mononitrate group and combined treatment group each have two patients because of economic and personal reasons not do the second measure pressure, according to two people's group because the pain medication can't tolerate adjustment.2 Portal vein pressure measurementPropranolol group and isosorbide mononitrate group without statistics more comparative differences (P>0.05), combined treatment group andisosorbide mononitrate group comparative differences have statistically significant (P<0.05), combined treatment group alone propranolol group compared with difference was statistically significant (P>0.05).3 Measuring gas molecules in plasmaDrug treatment with drugs before backdoor venous blood and peripheral blood concentration of nitric oxide in comparison, propranolol group of nitric oxide content is reduced, and the elevated to the other two groups. Drug treatment with drugs before backdoor venous blood and peripheral blood concentration of CO comparison, three groups are reduced. Drug treatment with drugs before backdoor venous blood and peripheral blood concentration in comparison, three groups H2S is rising.Conclusion:1 In cirrhosis portal hypertension treatment, according to Isosorbide Mononitrate or propranolol all can effectively reduce the patients with cirrhosis portal vein pressure (P<0.05). But small in patients with portal vein pressure alone more than Tim no obvious change.2 In cirrhosis portal hypertension treatment combination therapy effect is better than in more than Isosorbide Mononitratealone (P<0.05).3 Combination and designates propranolol comparison, portal vein pressure reducing's situation is not significant difference (P>0.05).4 H2S, NO, CO, etc in cirrhosis portal hypertension gas molecules of the formation and development process with important regulatory role.5 The portal vein pressure drugs not only can reduce portal vein pressure but also can effect the gas molecular generation and consumption such as NO CO H2S.