Application of non-selective β-blockers in patients with liver cirrhosis
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摘要: 非选择性β-受体阻滞剂(NSBBs)可有效降低肝静脉压力梯度,是肝硬化合并食管胃底静脉曲张破裂出血的一级和二级预防的一线用药,此外还可减轻重症肝病患者的炎性反应。但在肝硬化合并顽固性腹水、原发性细菌性腹膜炎以及肾功能损伤患者中的应用仍存在很大争议。因此,NSBBs用于预防食管静脉破裂出血时有窗口期,且用药剂量因人而异。此外,NSBBs还有心源性或非心源性副作用,用药时必须监测副反应,随时调整剂量。综述了NSBBs在预防食管胃底静脉破裂出血方面的最新研究进展。
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关键词:
- 肝硬化 /
- 高血压,门静脉 /
- 非选择性β-受体阻滞剂 /
- 食管和胃静脉曲张 /
- 综述
Abstract: Non-selective β-blockers (NSBBs) can effectively reduce hepatic venous pressure gradient (HVPG) , and are the first-line drugs for primary and secondary prevention of liver cirrhosis complicated by esophagogastric variceal bleeding.In addition, NSBBs can alleviate inflammatory response in patients with severe liver diseases.However, there are still controversies over the use of NSBBs in patients with liver cirrhosis complicated by intractable ascites, primary bacterial peritonitis, or kidney dysfunction.Therefore, NSBBs have a window period in the prevention of esophageal variceal bleeding with varying doses.Moreover, NSBBs have cardiogenic or non-cardiogenic side-effects, and thus side-effects should be closely monitored and the dose should be adjusted.This article reviews the latest research advances in NSBBs in preventing esophagogastric variceal bleeding. -
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