非选择性β受体阻滞剂对肝硬化合并食管胃底静脉曲张患者循环及肝肾综合征发生率的影响

摘要/Abstract

摘要： 目的探讨非选择性β受体阻滞剂(NSBBs)对肝硬化合并食管胃底静脉曲张患者循环及肝肾综合征(HRS)发生率的影响。方法选择2017年1月—2019年3月于我院消化科确诊并治疗的肝硬化合并食管胃底静脉曲张患者135例,根据治疗方案不同分为NSBBs组(n=85)和常规组(未使用NSBBs,n=50)。收集所有患者一般资料、实验室指标、血流动力学指标[静息心率(RHR)、动脉收缩压(SAP)、平均动脉压(MAP)]、HRS发生率。结果 2组RHR低于治疗前而MAP、SAP高于治疗前(P<0.05),且NSBBs组MAP、SAP低于常规组(P<0.05);NSBBs组HRS发生率高于常规组(P<0.05);曲张和腹水严重程度、MAP、SAP、NSBBs治疗为HRS发生高危因素(P<0.05)。结论 NSBBs可损害肝硬化合并食管胃底静脉曲张患者循坏系统,且在治疗过程中受到病情严重程度的影响可能会导致HRS发生率增高。

关键词: 非选择性β受体阻滞剂, 肝硬化合并食管胃底静脉曲张, 循环, 肝肾综合征, 影响

Abstract: Objective To investigate the effect of non-selective beta blockers (NSBBs) on circulation and incidence of hepatorenal syndrome (HRS) in patients with cirrhosis complicated with esophageal and gastric varices. Methods 135 patients with cirrhosis complicated with esophageal and gastric varices and treated in our hospital from January 2017 to March 2019 were divided into NSBBs group (n=85) and routine group (n=50) according to different treatment schemes. The general data, laboratory parameters, hemodynamic parameters [resting heart rate (RHR), arterial systolic pressure (SAP), mean arterial pressure (MAP)], and the incidence of HRS were collected. Results After treatment, RHR was decreased in both groups, and SAP and MAP were increased in both groups, moreover, NSBBs group had lower SAP and MAP than those in routine group (P<0.05). The incidence of HRS in NSBBs group was higher than that in routine group (P<0.05). Varicose and ascites severity, SAP, MAP and NSBBs treatment were high risk factors for HRS (P<0.05). Conclusion NSBBs can damage the circulatory system of cirrhosis patients with gastric varices, and may increase the incidence of HRS during the treatment due to the increased severity degrees.

Key words: NSBBs, Liver cirrhosis with gastric varices, Circulation, HRS, Effect

高淑娟, 耿西林. 非选择性β受体阻滞剂对肝硬化合并食管胃底静脉曲张患者循环及肝肾综合征发生率的影响[J]. 肝脏, 2020, 25(8): 806-809.

GAO Shu-juan, GENG Xi-lin. Effects of non-selective beta blockers on hemodynamics and incidence of hepatorenal syndrome in liver cirrhotic patients complicated with gastric varices[J]. Chinese Hepatolgy, 2020, 25(8): 806-809.

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