卡维地洛对肝硬化门静脉高压食管胃静脉曲张出血的防治作用研究进展

门静脉高压是食管胃静脉曲张出血的主要原因,有效降低门静脉压力梯度是预防食管胃静脉曲张出血的关键。卡维地洛是一类具有潜在的非心脏选择性的β受体和α受体阻滞剂,可通过降低门静脉压力进而减少食管胃静脉曲张的出血风险。本文就卡维地洛相比于传统的β受体阻滞剂如普萘洛尔或奈比洛尔、内镜下套扎、β受体阻滞剂联合硝酸酯类等治疗方案对食管胃静脉曲张出血的防治作用和不良反应进行分析,以期更好的指导临床治疗。

Carvedilol in the management of patients with portal hypertension

Since portal hypertension is the primary cause of gastroesophageal variceal bleeding, an effective reduction in the hepatic venous pressure gradient（HVPG） contributes mainly to the cure of variceal bleeding. As a non-selective β1/β2 and α1 adrenoceptor antagonist,carvedilol decreases the risk of variceal bleeding by the means of relieving portal hypertension. In this paper,we review the prevention of carvedilol on gastroesophageal variceal haemorrhage with emphasis on its outstanding features over classical beta-blockers such as propranolol and nebivolol,or other therapies as band ligation,or combination of propranolol and nitrates with the hope of providing a better guidance to clinic practice.