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Non-selective β-blockers in advanced cirrhosis: a critical review of the effects on overall survival and renal function.

作者信息

Blasco-Algora Sara, Masegosa-Ataz José, Alonso Sonia, Gutiérrez Maria-Luisa, Fernández-Rodriguez Conrado

机构信息

Gastroenterology Unit, Hospital Universitario Fundación Alcorcon, Madrid, Spain; University Rey Juan Carlos, Madrid, Spain.

出版信息

BMJ Open Gastroenterol. 2016 Dec 9;3(1):e000104. doi: 10.1136/bmjgast-2016-000104. eCollection 2016.

DOI:10.1136/bmjgast-2016-000104
PMID:28074149
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5174812/
Abstract

INTRODUCTION

Non-selective β-blockers (NSBBs) are widely prescribed in patients with cirrhosis for primary and secondary prophylaxis of bleeding oesophageal varices. Furthermore, it has been suggested that the clinical benefits of NSBBs may extend beyond their haemodynamic effects. Recently, a potentially harmful effect has been described in patients with refractory ascites or spontaneous bacterial peritonitis.

METHODOLOGY

A comprehensive literature search on β-blockers and cirrhosis survival using the electronic databases PubMed/MEDLINE, AMED, CINAHL and the Cochrane Central Register of Controlled Trials. Full-text manuscripts published over more than 35 years, from 1980 to April 2016 were reviewed for relevance and reference lists were cross-checked for additional pertinent studies regarding potential NSBB effects, especially focused on those concerned with survival and/or acute kidney injury (AKI).

DISCUSSION

The proposed review will be able to provide valuable evidence to help decision making in the use of NSBB for the treatment of advanced cirrhosis and highlights some limitations in existing evidence to direct future research.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/543a/5174812/fcf80e81d400/bmjgast2016000104f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/543a/5174812/39294b43ab6b/bmjgast2016000104f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/543a/5174812/fcf80e81d400/bmjgast2016000104f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/543a/5174812/39294b43ab6b/bmjgast2016000104f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/543a/5174812/fcf80e81d400/bmjgast2016000104f02.jpg

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2
The use of β-blockers is associated with a lower risk of developing hepatocellular carcinoma in patients with cirrhosis.在肝硬化患者中，使用β受体阻滞剂与肝细胞癌发生风险较低相关。
Eur J Gastroenterol Hepatol. 2016 Oct;28(10):1194-7. doi: 10.1097/MEG.0000000000000677.
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New advances in hepatocellular carcinoma.
Hepatol Int. 2020 Jan;14(1):24-34. doi: 10.1007/s12072-019-10004-1. Epub 2019 Dec 3.
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Management of refractory cirrhotic ascites: challenges and solutions.难治性肝硬化腹水的管理：挑战与解决方案
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World J Hepatol. 2016 Mar 28;8(9):421-38. doi: 10.4254/wjh.v8.i9.421.
4
Propranolol use beyond 6 months increases mortality in patients with Child-Pugh C cirrhosis and ascites.使用普萘洛尔超过6个月会增加Child-Pugh C级肝硬化和腹水患者的死亡率。
Hepatology. 2016 Nov;64(5):1806-1808. doi: 10.1002/hep.28575. Epub 2016 Jun 1.
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The Beneficial Effect of Beta-Blockers in Patients With Cirrhosis, Portal Hypertension and Ascites.β受体阻滞剂对肝硬化、门静脉高压和腹水患者的有益作用。
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