Clinical Observation Of Non-selective β-blocker Therapy On Portal Hypertensive Gastropathy

Background and Objective:With the development of the endoscope and its widespread clinical application, portal hypertension gastropathy caused more and more attention.Although it had not yet reached a consensus on its pathogenesis, but generally agreed that increased portal pressure was an important condition on portal hypertensive gastropathy.Propranolol was the most widely used drugs; and it was also recommended for the treatment of bleeding in portal hypertensive gastropathy.However, clinical studies on propranolol in the treatment of portal hypertension gastropathy was still little.Carvedilol was a novel non-selective β-blockers and also had al receptor receptor antagonistic effect;it may be superior to propranolol in the treatment of portal hypertension.But there was a lack of research data on carvedilol in portal hypertensive gastropathy treatment.There was lack of data about the’comparison of carvedilol and propranolol in the treatment of portal hypertension gastropathy.This study explored the relationship between portal hypertensive gastropathy and portal venous pressure,and compared carvedilol and propranolol in the treatment of portal hypertension gastropathy.Methods:We selected patients of portal hypertensive gastropathy from the Endoscopy Center of Eastern Shandong Provincial Hospital since April2010to March2014.And the pressure should be measured in patients who did not carry out endoscopic treatment.All patients were initially divided into three groups;Group A:Patients were not taking non-selective β-blockers;Group B:Patients were taking propranolol;Group C:Patients were taking carvedilol.Detailed records for those patients,including age,gender,hepatic venous pressure gradient,portal hypertensive gastropathy scores and other indicators.contrasting the scores of patients in each group. The scores of initial portal hypertensive gastropathy are PHG1,and the scores after3months are PHG2;and PHG3=PHG2-PHG1.SPSSv20.0software was used for analysis of the statistical data.Results:60patients were included in the study.Group A:including19patients,PHG1=1.74±1.10,PHG2=3.16±0.90P=0.26P>0.05,no statistically significant.Group B:including14patients,PHG1=3.36±1.65,PHG2=2.57±1.45; P=0.02, P<0.05,there was statistically significant.Group C:including27patients,PHG1=2.56±1.34,PHG2=1.63±1.71; P=0.00, P<0.05, There was statistically significant.Group A:PHG3=1.42±1.22Group B:PHG3=-0.79±1.37, Group C:PHG3=-0.93±1.30;Group A and Group B:P=0.00, P<0.05,there was statistically significant;Group A and Group C:P=0.00,P<0.05,there was statistically significant;Group B and Group C:P=0.94, P>0.05,no statistically significant.Conclusions:1.Increased portal pressure was an important condition for the occurrence of portal hypertensive gastropathy, but not the only condition; and there was no linear relationship between portal pressure and the severity of portal hypertensive gastropathy.2.Propranolol and carvedilol can significantly improve the portal hypertensive gastropathy.3.Propranolol and carvedilol was no significant difference in the treatment of portal hypertension gastropathy.