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Aliment Pharm Therap:肝硬化门静脉高压患者 口服牛磺酸可改善疗效

2018-01-19 应颖秋 环球医学

2018年1月,发表于《Aliment Pharmacol Ther》上的一项随机临床试验,考察了口服牛磺酸(6g/d)vs安慰剂对肝硬化患者门静脉压力的影响。

2018年1月,发表于《Aliment Pharmacol Ther》上的一项随机临床试验,考察了口服牛磺酸(6g/d)vs安慰剂对肝硬化患者门静脉压力的影响。

背景:氨基磺酸牛磺酸可降低内质网应激氧化压力,抑制肝星状细胞活化,从而造成肝硬化患者门静脉压力降低。

目的:旨在评估肝硬化和静脉曲张患者补充牛磺酸的血流动力学影响。

方法:肝静脉压力梯度(HVPG)≥12mmHg的患者纳入到这项前瞻性概念验证研究中。不允许同时服用非选择性β-受体阻滞剂。患者在评估HVPG应答前,接受了4周的口服牛磺酸(6g/d)或安慰剂。

结果:筛选了30例患者,22例患者纳入到有效性分析中(牛磺酸12例,安慰剂10例;64%为男性,平均52±11岁,Child A:9%,B:64%,C:27%,腹水:68%)。牛磺酸组,平均HVPG从基线的20mmHg(±4)降低到28天的18mmHg(±4)(平均相对改变,-12%;P=0.0093)。安慰剂组,平均HVPG从基线的20mmHg(±5)增加到28天的21mmHg(±5)(平均相对改变,+2%;P=0.4945)。牛磺酸对全身血流动力学无显着影响。接受牛磺酸的7/12例患者(58%)实现了HVPG应答>10%,而安慰剂组无(P=0.0053)。多变量线性模型中,牛磺酸组比安慰剂组HVPG显着降低得更大(绝对和相对改变的P分别为0.0091和0.0109)。治疗相关的不良事件包括胃肠道不适和疲劳,一般是轻度,两组相当。

结论:牛磺酸是安全的,可降低肝硬化患者门静脉压力。需要更多的牛磺酸补充的潜在作用机制和长期影响的研究。

原始出处:
Schwarzer R, Kivaranovic D, Mandorfer M,et al.Randomised clinical study: the effects of oral taurine 6g/day vs placebo on portal hypertension.Aliment Pharmacol Ther. 2018 Jan;47(1):86-94. doi: 10.1111/apt.14377. Epub 2017 Nov 3.

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    2018-11-13 jj000001
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  6. [GetPortalCommentsPageByObjectIdResponse(id=1697622, encodeId=efbf169e6228f, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Thu Mar 15 08:54:00 CST 2018, time=2018-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1808104, encodeId=4f9018081045b, content=<a href='/topic/show?id=e4548131286' target=_blank style='color:#2F92EE;'>#肝硬化门静脉高压患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81312, encryptionId=e4548131286, topicName=肝硬化门静脉高压患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Sun Jul 29 05:54:00 CST 2018, time=2018-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1738867, encodeId=47c71e38867df, content=<a href='/topic/show?id=6e566913df' target=_blank style='color:#2F92EE;'>#ERA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6913, encryptionId=6e566913df, topicName=ERA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e36234488643, createdName=124988c7m106暂无昵称, createdTime=Fri May 04 14:54:00 CST 2018, time=2018-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1787426, encodeId=34e01e8742607, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Tue Nov 13 09:54:00 CST 2018, time=2018-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1435152, encodeId=3d3e14351528e, content=<a href='/topic/show?id=6d779e14916' target=_blank style='color:#2F92EE;'>#门静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97149, encryptionId=6d779e14916, topicName=门静脉)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sun Jan 21 02:54:00 CST 2018, time=2018-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1486604, encodeId=6dc714866049d, content=<a href='/topic/show?id=28376e774e0' target=_blank style='color:#2F92EE;'>#牛磺酸#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67774, encryptionId=28376e774e0, topicName=牛磺酸)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27f8182618, createdName=gj0734, createdTime=Sun Jan 21 02:54:00 CST 2018, time=2018-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280048, encodeId=f1e428004863, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NcXNhUvfhzd2VdicMnaLeK2Im5gKx4Ucxd8Bwu6S7RG0uILBFQx5HTW2bU4VricDYlQqN20ibASSMYAeGrZrrTpy2Q/0, createdBy=b0041939716, createdName=hhh678, createdTime=Fri Jan 19 13:52:49 CST 2018, time=2018-01-19, status=1, ipAttribution=)]
    2018-01-21 gj0734
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    2018-01-19 hhh678

    henhao

    0

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