Clinical study of carvedilol combined with probiotics in preventing gastrointestinal bleeding and spontaneous peritonitis in patients with decompensation stage hepatitis B liver cirrhosis
Objective:To explore the value of carvedilol combined with probiotics in preventing gastrointestinal bleeding and spontaneous peritonitis in patients with decompensated hepatitis B cirrhosis.Methods:A total of 96 patients with decompensated hepatitis B cirrhosis who were hospitalized in our hospital from January 2019 to September 2020 were included as the study subjects.They were divided into 48 patients(50.0％)in the control group and 48 patients(50.0％)in the study group.The control group was treated with conventional treatment+propranolol,and the study group was treated with conventional treatment+carvedilol+probiotics.The changes of liver function,intestinal mucosal barrier function,inflammatory factors,and portal vein system hemodynamics before and after treatment between the two groups were compared,Kaplan Meier survival analysis was used to compare the two groups of patients'survival rates without gastrointestinal bleeding events and spontaneous peritonitis events during 2-year follow-up.Results:AST,ALT and total bilirubin in the two groups were significantly lower than those before treatment(P＜0.05),and AST,ALT and total bilirubin in the study group were significantly lower than those in the control group at the same time point(P＜0.05);The levels of diamine oxidase(DAO),endotoxin and D-lactic acid bacteria in the study group were significantly lower than those before treatment(P＜0.05),and were significantly lower than those in the control group at the same time point(P＜0.05);Tumor necrosis factor-α(TNF-α),C-reactive protein and interleukin-6(IL-6)in the study group decreased significantly compared with those before treatment(P＜0.05),and were significantly lower than those in the control group at the same time point(P＜0.05);The diameter of main portal vein,the maximum flow velocity of portal vein and the average flow velocity of portal vein in the two groups were significantly lower than those before treatment(P＜0.05),and significantly lower than those in the control group at the same time point(P＜0.05);The 2-year follow-up survival rate of patients in the study group without gastrointestinal bleeding and spontaneous peritonitis was significantly higher than that in the control group(P＜0.05).Conclusion:Carvedilol combined with probiotics can significantly reduce the risk of spontaneous peritonitis and gastrointestinal bleeding in patients with decompensated hepatitis B cirrhosis.
万方数据
维普
