特利加压素治疗肝硬化失代偿期并发肝肾综合征疗效观察

Terlipressin therapy for decompensated cirrhotic patients with hepatorenal syndrome

目的观察特利加压素治疗肝硬化失代偿期并发肝肾综合征疗效。方法 40例随机分成2组,每组20例,在内科综合治疗基础上,分别使用特利加压素和多巴胺。治疗期间观察患者临床症状、尿量、血清肌酐、血尿素氮、腹水消长情况及治疗后的转归。结果治疗结束后特利加压素组临床症状有明显改善,尿量由治疗前(768.5±265.5)ml增加到(1701.5±544.8)ml,血尿素氮由(19.1±4.8)mmol/L降到(13.6±4.5)mmol/L,血清肌酐由(208.2±67.8)μmol/L降到(134.3±37.8)μmol/L,这三项指标与治疗前比较,差异均有统计学意义(P均<0.05)。特利加压素组与多巴胺组比较,上述三项指标改变更明显,差异均有统计学意义(P均<0.05)。结论在内科综合治疗的基础上,特利加压素治疗肝硬化失代偿期并发肝肾综合征有较好疗效。

Objective To observe the effect of terlipressin on decompensated cirrhotic patients with hepatorenal syndrome （HRS）. Methods Totally 40 patients were randomly divided into 2 groups with 20 in each. Patients in the two groups were administered with terlipressin and dopamine, respectively, based on comprehensive medical treatmemt. The clinical symptoms, urine output, serum creatinine level, blood urea nitrogen, ascites and outcome were observed. Results In terlipressin group, the clinical symptoms improved significantly, the total urine output increased from （768.5±265.5） ml to （1701.5±544.8） ml, blood urea nitrogen decreased from （19.1±4.8） mmol/L to （13.6±4.5） mmol/L and serum creatinine decreased from （208.2±67.8） μmol/L to （134.3±37.8） μmol/L. The levers of the three markers were significantly different as compared with the pretherapy levels （P〈0.05）. There was significant difference in the post-therapy levels of the three markers between terlipressin group and dopamine group （P〈0.05）. Conclusion Based on the comprehensive medical treatment, terlipressin is effective for the treatment of decompensated cirrhosis complicated by HRS.