Rana Randeep, Sharma Sanchit, Ahmed Syed, Gupta Anany, Jun Wong Y, Gunjan Deepak, Saraya Anoop
Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, 110029, India.
Translational Gastroenterology Unit, John Radcliff Hospital, Oxford, United Kingdom.
J Clin Exp Hepatol. 2023 Mar-Apr;13(2):380-383. doi: 10.1016/j.jceh.2022.09.003. Epub 2022 Sep 20.
Non-selective beta-blockers (NSBBs) have a role in the management of portal hypertension. They are currently advocated in patients with clinically significant portal hypertension (CSPH) based on Baveno-VII consensus. Current survey aimed to evaluate the practice and perceptions of prescribing NSBBs in portal hypertension by gastroenterologists and hepatologists in Asia-Pacific region in patients with compensated cirrhosis. Out of 1500 gastroenterologists approached in the region, 328 gastroenterologists responded and completed the survey. 75% of the respondents were found not to be following practice of evaluating CSPH as they prescribed NSBBs in patients of compensated cirrhosis with high-risk varices only. Major concerns raised were non-availability of hepatic venous pressure gradient and reliable non-invasive tests as surrogate of CSPH to adapt PREDESCI methodology. While 56.7% used carvedilol as the preferred NSBB to treat patients with compensated cirrhosis, 43.3% used propranolol. This survey assessed the real-world scenario of prescribing NSBBs among practicing gastroenterologists/hepatologists in patients with compensated cirrhosis.
非选择性β受体阻滞剂(NSBBs)在门静脉高压的管理中发挥着作用。根据巴韦诺VII共识,目前主张在具有临床显著门静脉高压(CSPH)的患者中使用。本次调查旨在评估亚太地区胃肠病学家和肝病学家在代偿期肝硬化患者中开具NSBBs的实践情况和看法。在该地区联系的1500名胃肠病学家中,有328名胃肠病学家回复并完成了调查。结果发现,75%的受访者在仅为具有高危静脉曲张的代偿期肝硬化患者开具NSBBs时,没有遵循评估CSPH的做法。提出的主要担忧是缺乏肝静脉压力梯度以及可靠的非侵入性检测作为CSPH的替代指标来采用PREDESCI方法。虽然56.7%的人使用卡维地洛作为治疗代偿期肝硬化患者的首选NSBB,但43.3%的人使用普萘洛尔。这项调查评估了在代偿期肝硬化患者中,执业胃肠病学家/肝病学家开具NSBBs的实际情况。