| <P style="BACKGROUND: white; LINE-HEIGHT: 16.5pt"><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial"> 西班牙和加拿大学者的一项荟萃分析显示，血管紧张素受体拮抗剂</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">/</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial">血管紧张素转换酶抑制剂（</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">ARB/ACEI</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial">）可降低</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">Child Pugh A</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial">肝硬化患者的门静脉压力，而无不良事件。失代偿的患者如发生系统性肾素血管紧张素醛固酮系统（</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">RAAS</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial">）激活，有发生低血压和肾功能不全的危险性，因此这组治疗的有效性和安全性次于以局部肝的</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">RAAS</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial">系统为靶点的治疗。应进一步探讨这些药物是应作为</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">β</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial">受体阻滞剂（</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">BB</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial">）的替代还是补充。相关论文近期发表于《肝病学杂志》（详见：</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial"><A href="http://www.jhep-elsevier.com/article/S0168-8278(10)00380-6/abstract" target=_blank><FONT face=Arial color=#0000cc size=3>Renin–angiotensin–aldosterone inhibitors in the reduction of portal pressure: A systematic review and meta-analysis</FONT></A></SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial">）。</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial"> <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><o:p></o:p></SPAN></P>
<P style="BACKGROUND: white; LINE-HEIGHT: 16.5pt"><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial"> 该研究纳入了关于肝硬化和门静脉高压患者的有全文的对照研究。主要终点事件为</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">HVPG</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial">在治疗组和对照组的平均变化情况。两位独立的评价者进行了试验的选择和质量评估。研究针对</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">3</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial">例患者得试验数据进行了一次独立的荟萃分析</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial"> <o:p></o:p></SPAN></P><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-font-kerning: 1.0pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA"> 研究者从</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-fareast-font-family: 宋体; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">193</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-font-kerning: 1.0pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">个引文中，选择纳入了</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-fareast-font-family: 宋体; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">19</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-font-kerning: 1.0pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">例对照试验</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-fareast-font-family: 宋体; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">(n = 678)</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-font-kerning: 1.0pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">。与安慰剂对比，</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-fareast-font-family: 宋体; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">ARB/ACEI</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-font-kerning: 1.0pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">可使</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-fareast-font-family: 宋体; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">HVPG</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-font-kerning: 1.0pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">显著降低。这些试验中的</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-fareast-font-family: 宋体; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">3</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-font-kerning: 1.0pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">到</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-fareast-font-family: 宋体; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">4</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-font-kerning: 1.0pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">个试验的混合数据显示</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-fareast-font-family: 宋体; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">BB</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-font-kerning: 1.0pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">较</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-fareast-font-family: 宋体; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">ARB/ACEI</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-font-kerning: 1.0pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">能更好的降低肝静脉压力梯度（</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-fareast-font-family: 宋体; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">HVPG</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-font-kerning: 1.0pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">）。在肝硬化</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-fareast-font-family: 宋体; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">Child Pugh A</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-font-kerning: 1.0pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">患者中，</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-fareast-font-family: 宋体; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">ARB/ACEI(</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-font-kerning: 1.0pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">－</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-fareast-font-family: 宋体; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">17%</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-font-kerning: 1.0pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">，</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-fareast-font-family: 宋体; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">95%CI</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-font-kerning: 1.0pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">：－</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-fareast-font-family: 宋体; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">28</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-font-kerning: 1.0pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">～－</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-fareast-font-family: 宋体; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">6) </SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-font-kerning: 1.0pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">降低</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-fareast-font-family: 宋体; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">HVPG</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-font-kerning: 1.0pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">的水平与</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-fareast-font-family: 宋体; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">BB(</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-font-kerning: 1.0pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">－</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-fareast-font-family: 宋体; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">21%</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-font-kerning: 1.0pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">，</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-fareast-font-family: 宋体; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">95%CI</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-font-kerning: 1.0pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">：－</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-fareast-font-family: 宋体; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">32</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-font-kerning: 1.0pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">～－</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-fareast-font-family: 宋体; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">9)</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-font-kerning: 1.0pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">相似。各组的不良事件相似，有研究提示失代偿患者应用</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-fareast-font-family: 宋体; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">ARB/ACEI</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-font-kerning: 1.0pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">可出现血液动力学副作用。</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-fareast-font-family: 宋体; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA"> </SPAN> |
