Evolution in the understanding of the pathophysiological basis of portal hypertension: How changes in paradigm are leading to successful new treatments.
Evolution in the understanding of the pathophysiological basis of portal hypertension: How changes in paradigm are leading to successful new treatments.
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DOI：
10.1016/j.jhep.2015.01.003
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发表时间：
2015-04
影响因子：
25.7
通讯作者：
Shah VH
中科院分区：
文献类型：
--
作者：
Bosch J;Groszmann RJ;Shah VH
肝硬化的常见并发症之一是门静脉高压症，在过去的几十年里，其预后得到了重大改善。主要是由于引入了基于 20 世纪 80 年代发展的新病理生理学范式（思想概念）的理性治疗。最好的例子是使用非选择性β受体阻滞剂和加压素类似物、生长抑素及其类似物。对内脏和肝脏循环调节所涉及的分子机制的进一步深入了解导致了新治疗方法的出现，这些治疗方法所依据的证据表明，结构成分和血管活性成分不仅会增加肝血管阻力，还会增加血管生成。这些知识和未来的改进很可能会导致门静脉高压症的更有效治疗并在早期阶段有效预防其并发症。
Among the common complication of cirrhosis portal hypertension witnessed a major improvement of prognosis during the past decades. Principally due to the introduction of rational treatments based on new pathophysiological paradigms (concepts of thought) developed in the 1980s. The best example being the use of non-selective beta-blockers and of vasopressin analogs, somatostatin, and its analogs. Further refinement in the knowledge of the molecular mechanisms involved in the regulation of both the splanchnic and hepatic circulation has led to the emergence of new treatments, which are based on evidence that show not only structural but also vasoactive components increase the hepatic vascular resistance, as well as of angiogenesis. This knowledge and future improvements will most likely result in more effective treatment of portal hypertension and effective prevention of its complications in early stages.