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肝硬化中的β受体阻滞剂:循证医学的适应证与局限性

Beta-blockers in cirrhosis: Evidence-based indications and limitations.

作者信息

Rodrigues Susana G, Mendoza Yuly P, Bosch Jaime

机构信息

Swiss Liver Center, UVCM, Inselspital, Bern University Hospital, Department of Biomedical Research, University of Bern, Bern, Switzerland.

出版信息

JHEP Rep. 2019 Dec 20;2(1):100063. doi: 10.1016/j.jhepr.2019.12.001. eCollection 2020 Feb.

Abstract

Non-selective beta-blockers (NSBBs) are the mainstay of treatment for portal hypertension in the setting of liver cirrhosis. Randomised controlled trials demonstrated their efficacy in preventing initial variceal bleeding and subsequent rebleeding. Recent evidence indicates that NSBBs could prevent liver decompensation in patients with compensated cirrhosis. Despite solid data favouring NSBB use in cirrhosis, some studies have highlighted relevant safety issues in patients with end-stage liver disease, particularly with refractory ascites and infection. This review summarises the evidence supporting current recommendations and restrictions of NSBB use in patients with cirrhosis.

摘要

非选择性β受体阻滞剂(NSBBs)是肝硬化门静脉高压症治疗的主要手段。随机对照试验证明了其在预防初次静脉曲张出血和后续再出血方面的疗效。最近的证据表明,NSBBs可预防代偿期肝硬化患者发生肝脏失代偿。尽管有确凿数据支持在肝硬化患者中使用NSBBs,但一些研究强调了终末期肝病患者,特别是难治性腹水和感染患者的相关安全问题。本综述总结了支持目前关于NSBBs在肝硬化患者中使用的推荐和限制的证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83a0/7005550/b16669e7b9fd/gr1.jpg

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