预防肝硬化进展到脱补偿和死亡
Càndid Villanueva1,2,3, Dhiraj Tripathi4,5, Jaume Bosch6,7
1Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain. cvillanueva@santpau.cat.
Nature reviews. Gastroenterology & hepatology
|January 27, 2025
概括
预防晚期慢性肝病 (ACLD) 脱补偿是关键. 新的策略,包括非侵入性测试和β抑制剂,有助于管理补偿ACLD (cACLD) 并防止进展到失补偿ACLD (dACLD).
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 内部医学 内部医学
背景情况:
- 晚期慢性肝病 (ACLD) 在补偿 (cACLD) 和减补偿 (dACLD) 阶段呈现.
- 脱补偿,标志着,水出血和肝脏脑病变,导致高死亡率.
- 门高血压,特别是临床显著的门高血压 (CSPH) ≥10 mmHg,推动从cACLD向dACLD的进展.
研究的目的:
- 审查最近在管理cACLD中取得的进展,以防止脱补偿.
- 突出确定患有脱补偿风险的患者的策略.
- 讨论新的治疗方法的实施.
主要方法:
- 审查创新的研究和证据.
- 专注于用于识别CSPH的非侵入性测试 (NITs).
- 对病因学疗法和非选择性β抑制剂的评估.
主要成果:
- 非侵入性测试 (NITs) 可以以合理的准确性识别患有CSPH的患者.
- 病因疗法可以阻止或逆转肝硬化进展.
- 非选择性β-阻断剂有效地预防了CSPH的cACLD患者的脱补偿事件,主要是风.
结论:
- 新的策略为防止cACLD中脱补偿提供了显著的潜力.
- 使用NIT的患者选择对于有效的管理至关重要.
- 辅助疗法和β-阻断剂代表了管理cACLD和预防进展的关键进展.
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