中国肝硬化患者非选择性β受体阻滞剂使用若干问题的思考

Several hotspots and thinking in the use of non-selective β-blockers in Chinese cirrhosis patients

非选择性β受体阻滞剂是肝硬化门静脉高压治疗的一线药物,对降低门静脉压力和改善血流动力学紊乱均具有重要作用。然而,目前临床对其认识和重视程度仍显不足,中国肝硬化患者使用该类药物的获益并不显著。本文结合当前证据和中山大学附属第三医院消化内科治疗体会,对该类药物的临床使用率、剂量调整、治疗效果、预后影响等若干问题进行分析及思考,以期引起相关专科医师的重视。

Non-selectiveβ-blockers are the first-line treatment for portal hypertension through dual effect of decreasing portal venous pressure and improving hemodynamic dysfunction.However,Chinese patients may not benefit from the therapy due to low awareness and inadequate prescription in clinical practice.Based on current evidences and our clinical experiences,we debate several emerging issues including drug adherence,dose titration,adverse effect and prognostic benefit,hoping to catch the attention of digestive specialists and healthcare providers.