| Abstrakt: |
The effect of nebevolol, beta-blocker on the portal hypertension and renal blood flow and the safety of its use versus lisinopril, an angiotensin-converting enzyme inhibitor were examined in the patients with cirrhosis. 72 patients were examined (39 patients with cirrhosis of the liver without ascites - the 1st group and 32 patients with cirrhosis of the liver with ascites - the 2nd group. Trustworthy decrease of portal hypertension parameters (the decrease of portovenosis gradient of pressure (PPG) by 19,3% (p = 0,048) in the patients with liver cirrhosis of class A on Child-Pugh without ascites with nebevolol was revealed. The trust worthy changes of portal blood flow was not revealed in all examined patients with lisinopril. But these patients without ascites have demonstrated the improvement of the renal hemodynamic (renal functional reserve (RFR) by 56%, effective renal plasma flow (ERPF) by 17,3%). The lisinopril intake 5 mg a day declines PPG by 18,1%. The tendency of the reduction of the functional index due to the expressed hypotensive effect of nebevolol and lisinopril was revealed in all examined patients with liver cirrhosis. So it was demonstrated that for the management of the portal hypertension in the patients with liver cirrhosis is necessary to examine of functional renal condition to prevent the development of hepatorenal syndrome. |
