小剂量递增法服用厄贝沙坦治疗肝硬化腹水

Clinical Observation of Dose Escalated Irbesartan on Cirrhosis Ascites

目的探讨小剂量递增法服用厄贝沙坦治疗肝硬化腹水的治疗效果及安全性。方法选择75例肝硬化患者,在护肝、对症支持等治疗基础上,随机分成观察组(42例)和对照组(33例)。对比观察治疗前后2组症状、尿量、腹水变化、血浆肾素活性、血浆血管紧张素Ⅱ、醛固酮、尿微量蛋白、24h尿钠等指标,并观察不良反应。结果观察组治疗后每日尿量、腹水变化与对照组治疗前后比较,差异有统计学意义(P<0.05),治疗后的观察组与对照组血浆肾素活性、血浆血管紧张素Ⅱ、醛固酮、尿微量蛋白及24h尿钠等比较,差异有统计学意义(P<0.05),但有少量观察组患者的治疗效果不佳,且出现低血压及头晕等不适。结论对于Child-Pugh A级及Child-Pugh B级患者,在常规治疗基础上使用小剂量递增法服用厄贝沙坦治疗肝硬化腹水效果显著,安全性较好。

Objective To investigate the effects and safety of dose escalated irbesartan treatment of cirrhosis ascites. Methods 75 patients with cirrhosis, based on the treatment of liver protection and symptomatic support, were randomly divided into observation group （42 cases ）and control group （33 cases ）. Two group compared the indicators before and after treatment： symptoms, urine output, ascites changes, plasma renin activity （ PRA ）, plasma anglotensin Ⅱ （ A Ⅱ ）, aldosterone （ PAC ）, urine protein, urinary sodium excretion per 24h （UNa^＋ ）, etc. And adverse reactions were observed also. Results The daily urine output, ascites changes of observation group after treatment compared with those of the control group （ both before and after treatment ）, the difference was statistically significant （ P 〈 0.05 ）. Compare the indicators （ PRA, A Ⅱ, PAC, urine protein and UNa^＋ ） between the observation group and the control group after treatment, the difference was statistically significant （P 〈 0.05 ）. But few treatment effect were not beautiful in patient＇s of the observation group, and adverse reaction of hypotension and dizzy were obseved. Conclusion For the Child- Pugh A and Child-Pugh B class cirrhosis patients, the effect of dose-escalated Irbesartan based on the conventional treatment was significantly and security.