無腹水肝硬変患者の肝及び全身循環動態に及ぼす spironolactone の作用

概要

論文の詳細を見る
The effect of spironolactone on hepatic and systemic hemodynamics were investigated in twelve patients with portal hypertension due to liver cirrhosis without ascites to verify whether it may reduce portal pressure. The measurements of hemodynamics were performed prior and after the oral administration of spironolactone at daily doses of 100mg for four weeks.<BR>The hepatic venous pressure gradient (as WHVP-FHVP) significantly decreased by 24.7%. (baseline 16.9±3.6mmHg, spironolactone 12.6±4.2mmHg, p<0.01). However, no effect was on estimated hepatic blood flow and portal venous blood flow. Spironolactone caused a significant reduction of mean arterial blood pressure, cardiac output, plasma volume, body weight, and central venous pressure, while no change was observed in heart rate, systemic vascular resistence and hematocrit. The reduction rate of hepatic venous pressure gradient following spironolactone administration was not significantly correlated with the change of above mentioned parameters.<BR>These preliminary results suggest that spironolactone has a hypotensive effect on portal pressure in patients with cirrhosis. Factors other than vasoactive action should be considered as the possible mechanism for spironolactone induced hypotensive effect on portal pressure.