Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), Shenyang, China.
Postgraduate College, Shenyang Pharmaceutical University, Shenyang, China.
Adv Ther. 2020 Apr;37(4):1452-1463. doi: 10.1007/s12325-020-01250-z. Epub 2020 Feb 19.
Occlusive portal venous system thrombosis (PVT) is significantly associated with poor outcomes in cirrhotic patients. Nonselective β-blockers (NSBBs) may be associated with the development of PVT. However, the role of NSBBs in progressing thrombosis remains unclear.
Forty-three patients on whom contrast-enhanced computed tomography or magnetic resonance imaging was performed twice, and for whom there was detailed information regarding NSBBs, were eligible in this study, including 16 in the NSBBs group and 27 in the no NSBBs group. A composite endpoint of progressing thrombosis included the development of PVT in patients without PVT and aggravation of PVT in patients with PVT. Logistic regression analysis was employed to identify the effect of NSBBs on the progression of PVT.
At the last admission, 13 patients had progressing thrombosis. The incidence of progressing thrombosis was significantly higher in the NSBBs group than in the no NSBBs group [50.0% (8/16) vs. 18.5% (5/27), P = 0.030]. The use of NSBBs (odds ratio 4.400, 95% confidence interval 1.107-17.482, P = 0.035) was significantly associated with progressing thrombosis in univariate logistic regression analyses, but not significant (odds ratio 4.084, 95% confidence interval 0.488-34.158, P = 0.194) in multivariate logistic regression analyses.
NSBBs may play a role in the progression of PVT in liver cirrhosis. The benefits and risks of NSBBs in the management of liver cirrhosis should be fully weighed.
在肝硬化患者中，闭塞性门静脉系统血栓形成（PVT）与不良预后显著相关。非选择性β受体阻滞剂（NSBBs）可能与 PVT 的发展有关。然而，NSBBs 在促进血栓形成方面的作用尚不清楚。
这项研究纳入了 43 名接受过两次对比增强计算机断层扫描或磁共振成像检查且有详细 NSBB 使用信息的患者，包括 16 名 NSBB 组患者和 27 名无 NSBB 组患者。进展性血栓形成的复合终点包括无 PVT 患者发生 PVT 和有 PVT 患者 PVT 加重。采用 logistic 回归分析确定 NSBBs 对 PVT 进展的影响。
在最后一次入院时，13 名患者发生进展性血栓形成。NSBB 组进展性血栓形成的发生率明显高于无 NSBB 组[50.0%（8/16）比 18.5%（5/27），P=0.030]。在单变量 logistic 回归分析中，使用 NSBBs（比值比 4.400，95%置信区间 1.107-17.482，P=0.035）与进展性血栓形成显著相关，但在多变量 logistic 回归分析中无统计学意义（比值比 4.084，95%置信区间 0.488-34.158，P=0.194）。
NSBBs 可能在肝硬化患者 PVT 的进展中起作用。在肝硬化的管理中，应充分权衡 NSBBs 的利弊。
