Cristiana Iulia Dumitrescu 1, S.M. Cazacu 2, Daniela Dumitrescu 3, Anca Iovan Berbecaru 1, Florica Popescu 1
1 Pharmacology Discipline, UMF Craiova
2 Internal Medicine Vth year Discipline, UMF Craiova
3 Radiology and Medical Imaging Discipline, UMF Craiova
Abstract
Portal hypertension is characterized by increased portal pressure above 12 mm Hg. 2/3 of the patients also have esophageal varices and over 50% have a variceal bleeding during their life. Treatment with unselective beta-blockers had a great potential for lowering the risk of bleeding and mortality. Noninvasive techniques (transabdominal ultrasound including Doppler, upper digestive endoscopy, endoscopic ultrasound) may be used for the assessment of portal pressure. Material and method. We analyzed 52 patients with liver cirrhosis, Child A and B score, treated by internal medicine or gastroenterology specialty physicians between August 2007 and August 2008. Th e patients were treated with Propranolol for the reduction of portal pressure, the usual dosage was 80 mg/day. Results and discussions. After Propranolol therapy the hepatic blood fl ow had remained hepatofugal. After treatment we noted a reduction in the diameter of the portal vein by 2 mm, in the diameter of the splenic vein by 1 mm and in the diameter of the mesenteric vein by 2 mm. The median velocity of the portal blood flow was increased by 1 cm/ sec. The repermeabilisation of the umbilical vein was unchanged. We noted a reduction of the diameter of the esophageal varices between 10-32%. Secondary eff ects appeared in 49,9%, but were minor. Most of those eff ects disappeared after dose reduction. The thrombocyte count was seldom below 140000/mm3, values not associated with high risk on uncontrolled bleeding. Conclusions. The use of beta-blockers imposes a good compliance of the patients during treatment. Propranolol signifi cantly reduces variceal volume and pressure, fact associated with lower risk of ascites.