Multi-factor Analysis Of The Non-selective Beta Blockers In Reducing Hepatic Venous Pressure Gradient

Objectives:Cirrhosis is a serious and irreversible chronic liver lesions. The portal hypertension is one of its complications, which has a high mortality rate. The non-selective beta blockers (NSBBs) is the clinical recommended drugs for reducing portal vein pressure, however, only 1/3-1/2 patients respond well to it.This study aims to observe impact factors of hepatic vein pressure gradient (HVPG), the effect and Influence factors of non-selective beta blockers (NSBBs).Materials and Methods:After the examination of gastroscope, epigastrium MDCT (MDCT), blood routine tests, prothrombin time and liver biochemical tests,30 cases of patients with liver cirrhosis underwent hepatic venous pressure gradient (hvpg) measurements. All of the patients had a hepatic venous pressure gradient (hvpg)≥10mmhg.The study was to evaluate relationships between hepatic venous pressure gradient (hvpg) with history of variceal bleeding, etiology of liver disease, ascites, Child-Pugh class and the grade of esophageal variceal. Hepatic venous pressure gradient measurements were undertaken after receiving Carvedilol for 7 days. Comparion of "responders" (those that reduced HVPG<12mmhg or≥2o%) and "non-responders" (those that were not up to the standard) was taken to show if there had any significant differences in age, sex, etiology, bleeding history, ascites, basic heart rate and basic mean arterial pressure, hemoglobin, hematocrit, aspartate aminotransferase, alanine aminotransferase, albumin, serum bilirubin, prothrombin time, creatinine, urea nitrogen, Child-Pugh score, grade of esophageal varices, the MDCT score of paraesophageal varices and esophageal varices, main portal vein diameter, splenic vein diameter, superior mesenteric vein diameter, left gastric vein diameter, azygous vein diameter, splenic thickness, umbilical vein reascularization and portal vein thrombus.Result: Hepatic enous pressure gradient (HVPG) was related to ascites and Child-Pugh score, not to Bleeding history, etiology and gastroscope grade. There were 12 cases of responders(40%). No difference was finding between the responders and non-responders.Conclusion:Hepatic venous pressure gradient (HVPG) was associated with Ascites and Child-Pugh score, "response rate" was 40%, "non-response rate" was 60%. The degree of cirrhosis, liver reserve function and varicose veins did not influence the reduction of hepatic venous pressure gradient (HVPG) by non-selective beta blockers (NSBBs).