Sử dụng chẹn beta không chọn lọc trong xơ gan mất bù và suy gan cấp trên nền mãn tính

Current Hepatology Reports - Tập 21 - Trang 29-36 - 2022
Kohilan Gananandan1, Raj Mookerjee1, Rajiv Jalan1
1Liver Failure Group, Institute for Liver and Digestive Health, Division of Medicine, University College London, London, UK

Tóm tắt

Hiểu biết của chúng ta về các thuốc chẹn beta trong xơ gan đã có sự thay đổi lớn trong 40 năm qua. Tuy nhiên, vẫn còn những câu hỏi về độ an toàn của chúng trong tình trạng suy gan cấp và suy gan cấp trên nền mãn tính. Do những tình trạng này liên quan đến tỷ lệ mắc bệnh và tử vong đáng kể, việc đánh giá một cách có hệ thống các tài liệu gần đây là điều cần thiết để hướng dẫn các bác sĩ lâm sàng. Các hướng dẫn BAVENO mới nhất hiện nay khuyến cáo sử dụng carvedilol cho tất cả bệnh nhân có tăng huyết áp tĩnh mạch cửa lâm sàng đáng kể để ngăn ngừa tình trạng mất bù. Có nhiều dữ liệu chứng minh tính an toàn của việc sử dụng chẹn beta trong xơ gan mất bù, nhưng vẫn còn lo ngại về tình trạng cổ trướng kháng trị. Cũng có lợi ích về tỷ lệ tử vong ngắn hạn được chứng minh trong suy gan cấp trên nền mãn tính. Với các hướng dẫn mới nhất và chứng cứ gần đây, có vẻ như việc sử dụng chẹn beta sẽ tiếp tục gia tăng. Các nghiên cứu trong tương lai nên hướng tới việc xác định các dấu ấn sinh học có thể xác định ai sẽ được hưởng lợi từ chẹn beta và giúp hướng dẫn điều trị.

Từ khóa

#xơ gan #thuốc chẹn beta #suy gan cấp #tăng huyết áp tĩnh mạch cửa #carvedilol

Tài liệu tham khảo

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