Non-invasive response prediction in prophylactic carvedilol therapy for cirrhotic patients with esophageal varices.
肝硬化食管静脉曲张患者预防性卡维地洛治疗中的非侵入性反应预测。
Beta-blocker Elastography Hemodynamic response Portal hypertension
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摘要

BACKGROUND & AIMS:Non-selective beta-blockers (NSBBs) are the mainstay of primary prophylaxis of esophageal variceal bleeding in patients with liver cirrhosis. We investigated whether non-invasive markers of portal hypertension correlate with hemodynamic responses to NSBBs in cirrhotic patients with esophageal varices.
METHODS:In this prospective cohort study, 106 cirrhotic patients with high-risk esophageal varices in the derivation cohort received carvedilol prophylaxis, and completed paired measurements of hepatic venous pressure gradient, liver stiffness (LS), and spleen stiffness (SS) at the beginning and end of dose titration. LS and SS were measured using acoustic radiation force impulse imaging. A prediction model for hemodynamic response was derived, and subject to an external validation in the validation cohort (63 patients).
RESULTS:Hemodynamic response occurred in 59 patients (55.7%) in the derivation cohort, and in 33 patients (52.4%) in the validation cohort, respectively. Multivariate logistic regression analysis identified that ΔSS was the only significant predictor of hemodynamic response (odds ratio 0.039; 95% confidence interval 0.008-0.135; p 

译文

背景与目的: 非选择性 β 受体阻滞剂 (NSBBs) 是肝硬化患者食管静脉曲张出血一级预防的主要药物。我们研究了在肝硬化食管静脉曲张患者中,门脉高压的非侵入性标志物是否与对 NSBBs 的血流动力学反应相关。
方法: 在这项前瞻性队列研究中,在衍生队列中有 106 名患有高危食管静脉曲张的肝硬化患者接受了卡维地洛预防治疗,并完成了肝静脉压力梯度的配对测量, 剂量滴定开始和结束时的肝脏硬度 (LS) 和脾脏硬度 (SS)。使用声辐射力脉冲成像测量 LS 和 SS。导出了血流动力学反应的预测模型,并在验证队列 (63 例患者) 中接受外部验证。
结果: 在衍生队列中,59 名患者 (55.7%) 和 33 名患者 (52.4%) 分别出现血流动力学反应。多变量逻辑回归分析确定 Δ ss 是血流动力学反应的唯一重要预测因子 (比值比 0.039; 95% 置信区间 0.008-0.135; p  

Carvedilol

心血管 原发性高血压 药物
概述  :  

适应证1.用于原发性高血压的治疗,可单独使用或与其他抗高血压药特别是噻嗪类利尿药联合使用。2.其他治疗作用,在此不作详细叙述。不良反应1.中枢神经系统:偶尔发生轻度头晕、头痛、乏力,特别是在治疗早期。抑郁、睡眠紊乱、感觉异常罕见。2.心血管系统:治疗早期偶尔有心动过缓、直立性低血压,很少有突然晕倒。外周循环障碍(四肢发凉)不常见,可使原有的间歇性跛行(行走一段路程后腿部肌肉疼痛,酸胀无力,继续行走的话,因为症状加重而被迫停止,休息片刻,疼痛缓解,可继续行走,如此反复),或有雷诺现象(四肢冰冷)的

Carvedilol

释义   卡维地洛

例句   But little is known about the role of carvedilol on cardiac energy metabolism as yet. 

但卡维地洛在肥厚心肌能量代谢中的作用,目前尚不清楚。


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