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程雅玮, 朱晓龙, 张春清. 卡维地洛防治肝硬化门静脉高压研究进展[J]. 中国临床医学, 2024, 31(3): 374-378. DOI: 10.12025/j.issn.1008-6358.2024.20240603
引用本文: 程雅玮, 朱晓龙, 张春清. 卡维地洛防治肝硬化门静脉高压研究进展[J]. 中国临床医学, 2024, 31(3): 374-378. DOI: 10.12025/j.issn.1008-6358.2024.20240603
CHENG Yawei, ZHU Xiaolong, ZHANG Chunqing. Research progress on the application of carvedilol in the treatment and prevention of portal hypertension in cirrhosis patients[J]. Chinese Journal of Clinical Medicine, 2024, 31(3): 374-378. DOI: 10.12025/j.issn.1008-6358.2024.20240603
Citation: CHENG Yawei, ZHU Xiaolong, ZHANG Chunqing. Research progress on the application of carvedilol in the treatment and prevention of portal hypertension in cirrhosis patients[J]. Chinese Journal of Clinical Medicine, 2024, 31(3): 374-378. DOI: 10.12025/j.issn.1008-6358.2024.20240603

卡维地洛防治肝硬化门静脉高压研究进展

Research progress on the application of carvedilol in the treatment and prevention of portal hypertension in cirrhosis patients

  • 摘要: 肝硬化是由多种原因引起的肝脏慢性炎症损伤导致的严重疾病,常并发门静脉高压。门静脉高压形成的主要原因包括肝内血管阻力增加和门静脉血流量增加。卡维地洛是第3代非选择性β受体阻滞剂(NSBB),具有α1受体阻滞作用,降低门静脉压力的作用优于传统NSBB。卡维地洛通过多重机制降低肝静脉压力梯度(HVPG),预防静脉曲张破裂出血,延长患者生存期。本文总结了卡维地洛在门静脉高压治疗中的作用机制及具体应用,重点探讨其在静脉曲张一级和二级预防中的效果及其对肝硬化合并顽固性腹水患者生存的影响。

     

    Abstract: Cirrhosis is a severe disease caused by chronic inflammatory damage to the liver due to various factors, often complicated by portal hypertension. The primary causes of portal hypertension include increased intrahepatic vascular resistance and increased portal venous blood flow. Carvedilol, a third-generation non-selective beta-blocker (NSBB) with alpha-1 receptor-blocking role, is superior to traditional NSBBs in reducing portal pressure. It is believed that carvedilol significantly reduces hepatic venous pressure gradient (HVPG) through multiple mechanisms, prevents variceal bleeding, and extends patient survival. This paper reviews the mechanisms and clinical applications of carvedilol in the treatment of portal hypertension, focusing on its efficacy in the primary and secondary prevention of varices and its impact on the survival of cirrhotic patients with refractory ascites.

     

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