非选择性β受体拮抗剂在肝硬化门静脉高压患者中的合理应用

doi:10.3969/j.issn.1672-5069.2014.05.031

摘要/Abstract

摘要： 曲张静脉出血是肝硬化门静脉高压患者最常见和最严重的并发症之一。近三十余年来,尽管对其治疗取得了进展,但其相关病死率仍达15%~20%左右。不仅如此,曲张静脉出血常导致肝功能进一步的恶化,也是诱发肝硬化其他并发症的共同启动因素。因此,预防曲张静脉首次出血与再出血是提高失代偿期肝硬化和食管曲张静脉患者生存率的重要措施。非选择性β受体阻滞剂（nonselective beta-blockers, NSBB）因具有明确地降低肝静脉压力剃度的作用,被推荐用于预防曲张静脉首次出血和再出血。尽管该类药物具有耐受性好、口服方便和经济实惠的优点,但在使用过程中因存在副作用和潜在的不良作用,一般推荐应有选择地用于那些高危的曲张静脉患者。

关键词: 肝硬化, 门静脉高压, 曲张静脉出, 血β, 受体阻滞剂

Abstract: It is well established that variceal hemorrhage is one of the most common and severe complications in patients with liver cirrhosis and portal hypertension. Despite the advances in the last three decades in its treatment, mortality from variceal bleeding is still around 15%~20%. Moreover,variceal bleeding often leads to deterioration of liver functions. Furthermore,it is a common trigger for other complications of liver cirrhosis. Therefore, primary and secondary preventions of variceal hemorrhageare important strategy for improving the survival in patients with decompensated liver cirrhosis and esophageal varices. Nonselective beta-blockers（NSBB） have been shown to reduce the hepatic venous portal pressure gradient and are recommended for the prevention of the first variceal hemorrhage and rebleeding. The advantages of NSBB therapy are good tolerance,oral administrationand lowcost.However,the indication of NSBB should be limited to patientswith a high risk of variceal bleeding because of the potential side effects of the therapy.

涂传涛综述, 王吉耀审校. 非选择性β受体拮抗剂在肝硬化门静脉高压患者中的合理应用[J]. 实用肝脏病杂志, 2014, 17(5): 553-556.

Tu Chuantao, Wang Jiyao. Insight into the rational use of nonselective beta-blockers in cirrhotic patients with portal hypertension[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2014, 17(5): 553-556.

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