了解临床意义上的门高血压:对病原,诊断和治疗进行深入研究
Emma Vanderschueren1, Schalk van der Merwe1, Wim Laleman1,2
1Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium (Emma Vanderschueren, Schalk van der Merwe, Wim Laleman).
Annals of gastroenterology
|July 23, 2025
概括
临床显著的门高血压 (CSPH) 是补偿性晚期慢性肝病 (cACLD) 进展的关键预测因素. 需要新的诊断和治疗策略来有效管理CSPH并个性化患者护理.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 临床诊断 临床诊断 临床诊断
背景情况:
- 临床显著的门高血压 (CSPH) 是补偿性晚期慢性肝病 (cACLD) 疾病进展的关键生物标志物.
- 慢性肝损伤导致门口压力增加,增加并发症和死亡风险.
- 在补偿患者中,诊断CSPH具有挑战性,但大约60%的患者有它,这代表了一个关键的干预窗口.
研究的目的:
- 审查目前的诊断局限性和新兴的工具,用于在cACLD中检测CSPH.
- 讨论CSPH在指导治疗决策中的作用以及对新疗法的需求.
- 要突出在管理CSPH.转向个性化医疗的转变.
主要方法:
- 关于cACLD中CSPH诊断和管理的当前文献的综述.
- 讨论既有和新型的诊断技术,包括侵入性和非侵入性方法.
- 对治疗选择的分析,重点是β-阻断剂和需要新的治疗方法.
主要成果:
- 肝静脉压梯度是黄金标准,但不适合广泛使用.
- 新兴的工具,如内镜超声波,成像,弹性图像和血清标记器,为CSPH检测提供了替代方案.
- 非选择性β抑制剂是唯一批准的治疗方法,但并不普遍有效,这表明需要新的选择.
结论:
- 准确和实用的CSPH检测对于对cACLD及时干预至关重要.
- 迫切需要除了β-阻断剂之外的额外疗法和更好的治疗反应评估方法.
- 对诊断,治疗和随访的个性化方法有望改善CSPH患者的治疗结果.
更多相关视频
相关概念视频
Esophageal Varices-II: Clinical Features and Management
145
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
145
Esophageal Varices-I: Introduction
345
Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
345
Hepatic Portal System
2.3K
The hepatic portal system, a critical part of our circulatory framework, transports nutrient-laden, deoxygenated blood from the gastrointestinal tract and spleen to the liver. This ingenious system plays an indispensable role in maintaining our body's metabolic equilibrium.
At its core, the hepatic portal vein is the result of a confluence of the superior and inferior mesenteric veins along with the splenic vein. Each of these veins has a unique role. The superior mesenteric vein is...
At its core, the hepatic portal vein is the result of a confluence of the superior and inferior mesenteric veins along with the splenic vein. Each of these veins has a unique role. The superior mesenteric vein is...
2.3K
Chronic Pancreatitis II: Collaborative Care
128
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
128
Esophageal Perforation-II: Clinical Manifestations and Management
150
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
150
Barrett Esophagus-II: Clinical Manifestations and Management
312
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
312


