奥曲肽辅助特利加压素在肝硬化失代偿期并发肝肾综合征治疗中的疗效

摘要/Abstract

摘要： 目的汇总失代偿期肝硬化合并肝肾综合征(HRS)患者相关病例资料,并探究奥曲肽辅助特利加压素的疗效。方法 2015年2月至2019年11月我院收治肝硬化失代偿期合并HRS患者92例,年龄(50.4±9.8)岁。患者纳入时符合肝硬化失代偿期、HRS相关疾病诊断要求。患者随机分为观察组(n=46)及对照组(n=46)。对照组予特利加压素治疗;观察组予特利加压素治疗外,同时辅助奥曲肽治疗。计量资料以(±s)表示,t检验比较;计数资料以百分比(%)表示,卡方检验比较。结果观察组[(1 050.6±325.4)mL]治疗后平均24 h尿量明显多于对照组患者[(687.0±248.5)mL,P=0.002<0.05],观察组[(54.0±4.2)kg]治疗后体重明显低于对照组患者[(58.7±6.0)kg,P=0.038<0.05],而两组患者年龄、性别、Child-Pugh分级及肝硬化病因均无明显差异(P>0.05)。观察组、对照组研究前后总胆红素、直接胆红素、白蛋白、尿素氮、肌酐及钠离子均有显著性差异(P<0.05)。同时,研究发现观察组[(14.0±11.2)μmol/L]总胆红素显著低于对照组[(21.4±13.2)μmol/L,P=0.014<0.05],观察组[(33.4±6.8)g/L]白蛋白显著高于对照组[(29.4±8.1)g/L,P=0.036<0.05],观察组[(11.3±3.0)mmol/L]尿素氮显著低于对照组[(15.4±5.2)μmol/L,P=0.020<0.05],而两组患者研究后直接胆红素、肌酐及钠离子并无显著性差异(P>0.05)。结论奥曲肽辅助特利加压素治疗肝硬化失代偿期并发HRS患者能够增加尿量、降低体重,可以减少总胆红素、尿素氮的产生并能够增加白蛋白。

关键词: 肝硬化, 肝肾综合征, 特利加压素, 奥曲肽

Abstract: Objective To summarize the clinical data of patients with decompensated liver cirrhosis complicated with hepatorenal syndrome (HRS), and to investigate the efficacy of octreotide plus terlipressin in the treatment of these patients.Methods From February 2015 to November 2019, 92 patients with decompensated cirrhosis complicated with HRS were treated in our hospital. The average age was (50.4 ± 9.8) years. Patients who met the diagnostic criteria of decompensated liver cirrhosis and HRS-related diseases were included. They were randomly divided into an observation group (n=46) and a control group (n=46). The control group was treated with terlipressin, and the observation group was treated with terlipressin and octreotide at the same time. The measurement data were presented as (±s), and analyzed by t-test; the counting data were expressed as percentages (%), and analyzed by chi-square test.Results The average 24-hour urine output of the observation group [(1 050.6 ± 325.4) mL] after treatment was significantly higher than that of the control group [(687.0 ± 248.5) mL, P=0.002]. And the average weight of the observation group [(54.0 ± 4.2) kg] after treatment was significantly lower than that of the control group [(58.7 ± 6.0) kg, P=0.038]. There were no significant differences in age, sex, Child-Pugh grade and etiology of liver cirrhosis between the 2 groups (P>0.05). There were significant differences in total bilirubin, direct bilirubin, albumin, urea nitrogen, creatinine and sodium ions before and after treatment in 2 groups (all P<0.05). After treatment, the total bilirubin and urea nitrogen in the observation group [(14.0 ± 11.2) μmol/L, (11.3 ± 3.0) mmol/L] were significantly lower than those in the control group [(21.4 ± 13.2) μmol/L, (15.4 ± 5.2) mmol/L, both P<0.05]. The albumin in the observation group [(33.4 ± 6.8) g/L] was significantly higher than that in the control group [(29.4 ± 8.1) g/L, P<0.05]. However, there was no significant difference in posttreatment direct bilirubin, creatinine and sodium ions between the 2 groups (P>0.05).Conclusion Octreotide combined with terlipressin in the treatment of decompensated liver cirrhosis complicated with HRS can increase urine volume and albumin, reduce body weight, the production of total bilirubin and urea nitrogen.

Key words: Liver cirrhosis, Hepatorenal syndrome, Terlipressin, Octreotide

胡掌朝, 白雪, 程帅师, 安俊丽. 奥曲肽辅助特利加压素在肝硬化失代偿期并发肝肾综合征治疗中的疗效[J]. 肝脏, 2020, 25(12): 1294-1296.

HU Zhang-chao, BAI Xue, CHENG Shuai-shi, AN Jun-li. Analysis of the therapeutic efficacy of octreotide combined with terlipressin in hepatorenal syndrome with decompensated liver cirrhosis[J]. Chinese Hepatolgy, 2020, 25(12): 1294-1296.

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