多普勒超声评估辛伐他汀给药前后肝硬化患者的门静脉压力 -

StephenW

                                                                                                                                                                  Clinical trial
Evaluation of portal pressure by doppler ultrasound in patients with cirrhosis before and after simvastatin administration – a randomized controlled trial [version 1; referees: awaiting peer review]
Nadia Elwan1, Raafat Salah1, Manal Hamisa2, Ebtsam Shady1, Nehad Hawash1, Sherief Abd-Elsalam
https://orcid.org/0000-0003-4366-2218
1
Author details
1 Department of Tropical Medicine, Faculty of Medicine, Tanta University, Tanta, Gharbia Governorate, Egypt
2 Department of Radiology, Tanta University, Tanta, Gharbia Governorate, Egypt

Nadia Elwan
Roles: Investigation, Methodology, Supervision, Writing – Original Draft Preparation, Writing – Review & Editing
Raafat Salah
Roles: Investigation, Methodology, Writing – Original Draft Preparation
Manal Hamisa
Roles: Investigation, Methodology, Writing – Original Draft Preparation
Ebtsam Shady
Roles: Data Curation, Investigation, Methodology, Writing – Original Draft Preparation
Nehad Hawash
Roles: Investigation, Methodology, Writing – Original Draft Preparation
Sherief Abd-Elsalam
Roles: Conceptualization, Data Curation, Investigation, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing

Grant information
Abstract
Background: Portal hypertension is one of the most frequent complications of cirrhosis. β-adrenergic blockers, with or without organic nitrates, are currently used as hypotensive agents. Statins such as simvastatin seem to be safe for patients with chronic liver diseases and exert multiple pleiotropic actions. This study aimed to assess PTH using Doppler ultrasound in patients with cirrhosis before and after simvastatin administration.
Methods: This randomized controlled clinical trial was conducted on 40 patients with cirrhosis who were randomized into 2 groups: group I included 20 patients with cirrhosis who were administered 20 mg of simvastatin daily for 2 weeks and then 40 mg daily for another 2 weeks, and group II included 20 patients with cirrhosis who did not receive simvastatin as a control group. All patients underwent full clinical examination, laboratory investigations, and abdominal Doppler ultrasound at baseline and after 30 days to evaluate portal vein diameter, blood flow volume, direction and velocity of portal vein blood flow, hepatic artery resistance and pulsatility indices, splenic artery resistance index, portal hypertension index (PHI), liver vascular index, and modified liver vascular index (MLVI).
Results: There was a highly significant decrease in the hepatic artery resistance index  in group I, from 0.785 ± 0.088 to 0.717 ± 0.086 (P < 0.001). There was a significant decrease in the PHI in group I , from 3.915 ± 0.973 m/sec to 3.605 ± 1.168 m/sec (P = 0.024). Additionally, there was a significant increase in the MLVI in group I from 11.540 ± 3.266 cm/sec to 13.305 ± 3.222 cm/sec, an increase of 15.3% from baseline (P = 0.009). No significant adverse effects were detected.
Conclusions: Simvastatin is safe and effective in lowering portal hypertension.
[ClinicalTrials.gov Identifier: NCT02994485]  

StephenW

临床试验
多普勒超声评估辛伐他汀给药前后肝硬化患者的门静脉压力 - 一项随机对照试验[版本1;裁判：等待同行评议]
Nadia Elwan1，Raafat Salah1，Manal Hamisa2，Ebtsam Shady1，Nehad Hawash1，Sherief Abd-Elsalam
https://orcid.org/0000-0003-4366-2218
1
作者的细节
1埃及Gharbia省坦塔塔塔大学医学院热带医学系
2埃及Gharbia省Tanta塔塔大学放射学系

纳迪亚埃尔旺
角色：调查，方法，监督，写作 - 原稿准备，写作 - 评论和编辑
Raafat Salah
角色：调查，方法，写作 - 原稿草稿
Manal Hamisa
角色：调查，方法，写作 - 原稿草稿
Ebtsam Shady
角色：数据管理，调查，方法，写作 - 原稿草稿
Nehad Hawash
角色：调查，方法，写作 - 原稿草稿
Sherief Abd-Elsalam
角色：概念化，数据管理，调查，方法论，写作 - 原稿准备，写作 - 评论和编辑

授予信息
抽象
背景：门静脉高压症是肝硬化最常见的并发症之一。含有或不含有机硝酸盐的β-肾上腺素能阻滞剂目前用作降压药。他汀类药物如辛伐他汀似乎对慢性肝病患者是安全的，并发挥多种多效作用。本研究旨在评估施用辛伐他汀前后肝硬化患者多普勒超声的PTH。
方法：对40例肝硬化患者进行随机对照临床试验，随机分为2组：I组20例肝硬化患者，每日服用辛伐他汀20 mg，2周，然后每日40 mg，再服用2周;第二组包括20例未接受辛伐他汀作为对照组的肝硬化患者。所有患者均在基线和30天后进行全面的临床检查，实验室检查和腹部多普勒超声评估门静脉内径，血流量，门静脉血流的方向和速度，肝动脉阻力和搏动指数，脾动脉阻力指数，门脉高压指数（PHI），肝血管指数和改良肝血管指数（MLVI）。
结果：I组肝动脉阻力指数下降明显，从0.785±0.088降至0.717±0.086（P <0.001）。第一组的PHI从3.915±0.973米/秒下降到3.605±1.168米/秒（P = 0.024）。此外，I组的MLVI从11.540±3.266cm / sec增加到13.305±3.222cm / sec，比基线增加了15.3％（P = 0.009）。未检测到显着的不良反应。
结论：辛伐他汀安全有效地降低门静脉高压症。
[ClinicalTrials.gov标识符：NCT02994485]

StephenW

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