低用量の塩酸プロプラノロール投与により門脈圧亢進性胃症からの出血がコントロールしえた肝硬変症の1高齢者例

抄録

A 70-year-old female patient with liver cirrhosis (unknown etiology) was diagnosed as hemorrhagic portal hypertensive gastropathy by upper GI endoscopy and admitted to our hospital 4 times because of iron deficiency anemia since January 1991.
In April, 1996 (76yr) , She complained progressive dyspnea on physical exertion and fainting. Laboratory data revealed severe iron deficiency anemia. The upper GI endoscopy (June 19th) showed multiple protruding red marks with oozing type hemorrhage at cardia and antrum in the stomach. Propranolol administration was started to relieve portal hypertension at the dose of 30mgTID from July 2nd. On the 5th day, heart rate decreased 60 to 42 bpm (30%) , blood pressure 120/60 to 82/64mmHg and her symptom was getting worse. So the dose of propranolol was reduced to 20mgBID from July 15th. Heart rate decrement was 60 to 50 bpm (16.7%) , blood pressure 100/60mmHg and her symptom was improved. The upper GI endoscopic findings of PHG were improved and active hemorrhage was not observed. On hemorrhagic PHG in the elderly, adequate low dose medical treatment was suggested to be useful and safe.