Additionofsimvastatintocarvedilolnonresponders:Anewpharmacologicaltherapyfortreatmentofportalhypertension

摘要： AIMTodeterminewhetheradditionofsimvastatincouldbeanimportantpharmacologicalrescuetherapyforcarvedilolnon-responders.METHODSOnehundredandtwoconsecutivepatientsofcirrhosisofliverwithsignificantportalhypertensionwereincluded.Hepaticvenouspressuregradient(HVPG)wasmeasuredatthebaselineandafterproperoptimizationofdose;chronicresponsewasassessedat3mo.Carvedilolnon-respondersweregivensimvastatin20mgperday(increasedto40mgperdayatday15).Carvedilolplussimvastatinwascontinuedfor1moandhemodynamicresponsewasagainmeasuredat1mo.RESULTSAtotalof102patientswithmeanageof58.3±6.6yearswereincluded.MeanbaselineHVPGwas16.75±2.12mmHgandafteroptimizationofdoseandreassessmentofHVPGat3mo,meanreductionofHVPGfrombaselinewas5.5±1.7mmHgand2.8±1.6mmHgamongrespondersandnon-respondersrespectively(P<0.001).Additionofsimvastatintocarvedilolnon-respondersresultedinsignificantresponsein16patients(42.1%)andthusoverallresponsewithcarvedilolandcarvedilolplussimvastatinwasseenin78patients(80%).Twopatientswereremovedinchronicprotocolstudywithcarvedilolandthreepatientswereremovedincarvedilolplussimvastatinstudyduetosideeffects.CONCLUSIONAdditionofsimvastatintocarvedilolnon-respondersmayprovetobeanexcellentrescuetherapyinpatientswithportalhypertension. （共8頁）