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Annals of Nuclear Medicine and Molecular Imaging

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篇名 Acute Effect of Isosorbide-5-mononitrate on Renal Function in Patients with Liver Cirrhosis
卷期 12:4
並列篇名 Isosorbide-5-mononitrate對肝硬化病人腎臟功能之急性影響
作者 陳詩典謝志芳蔡世傳
頁次 189-194
關鍵字 肝硬化腎功能有效腎血流量急性影響Liver cirrhosisIsosorbide 5 mononitrateRenal functionEffective renal plasma flowAcute effect
出刊日期 199912

中文摘要

背景:Isosorbide-5-mononitoate(IS-5-MO)被報導能夠預防肝硬化病人食道靜脈瘤破裂出血。然而近有些報導亦指出IS-5-MO可能會降低腎臟功能。本研究將利用核醫腎有效血流量造影檢查(ERPF)及血中BUN、creatinine的濃度來評估IS-5-MO對肝硬化病患腎功能的急性影響。
方法:本研究包括15位肝硬化病人,每位病人在口服20mgIS-5-MO前後均接受ERPF、BUN和creatinine之檢測,其中ERPF乃使用核醫碘-131-OIH腎臟造影檢查得知。
結果:本研究結果顯示病患在服用20mgIS-5-MO之後,ERPF值很明顯地由平均414.1ml/min降至平均381.2ml/min,以成對Student's t-test統計其P值為0.047。相反地,血中BUN及creatinine之濃度則並未有明顯變化,其P值分別為0.79及1.00。
結論:IS-5-MO有可能造成肝硬化病患ERPF值之下降,因此使用上務須小心。

英文摘要

Background: Isosorbide-5-mononitrate (IS-5-MO) has been shown to be useful in preventing variceal bleeding in cirrhotic patients. However, recent studies have reported that IS-5-MO may compromise renal function. In this study, we monitored the effective renal plasma flow (ERPF) and serum creatinine and blood urea nitrogen (BUN) concentrations to evaluate the acute effect of IS-5-MO on renal function in patients with cirrhosis.
Materials and Methods: Fifteen cirrhotic patients were included. Their ERPF and serum creatinine and BUN concentrations were checked before and after oral administration of a single dose of 20 mg IS-5-MO. The ERPF was measured by an 131I-orthoiodohippurate (131-OIH) renal study, a well-established method.
Results: Our data showed that a significant decrease in mean ERPF value from 414.1 mi/rain to 381.2 ml/min occurred after administration of 20 mg IS-5-MO. The P value was 0.047 using a paired Student's t-test. On the contrary, no obvious changes in serum creatinine and BUN concentrations were noted after IS-5-MO adminis- tration. The P values were 0.79 and 1.00 for BUN and creatinine, respectively, by paired Student's t tests.
Conclusion: Based on our data, ERPF value may decrease after oral administration of a single dose of 20 mg IS-5-MO. The administration of IS-5-MO should be careful in patients with liver cirrhosis.

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