特利加压素联合前列地尔治疗高龄患者肝肾综合征疗效观察

Efficacy Observation of Terlipressin Combined with Alprostadil in the Treatment of Hepatorenal Syndrome in Elderly Patients

目的:观察特利加压素联合前列地尔治疗高龄患者肝肾综合征(HRS)的疗效及安全性。方法:32例高龄HRS患者分为对照组(14例)和治疗组(18例)。对照组常规治疗,治疗组在常规治疗基础上,联用特利加压素和前列地尔7～14 d。观察患者临床症状、尿量、血肌酐、尿素氮等变化,以及不良反应、终止治疗事件及治疗后的转归。结果:与对照组比较,治疗组临床症状均得到不同程度的改善(P<0.05)。治疗组治疗1 d后尿量明显增加(P<0.01),血肌酐、尿素氮水平明显下降(P<0.05),治疗7 d后较3 d后尿量进一步增加,血肌酐、尿素氮进一步降低(P<0.05),且均较对照组同期差异显著(P<0.01或0.05)。治疗期间,治疗组无1例死亡,对照组有5例(35.7%)死亡,差异有统计学意义(P<0.05)。结论:特利加压素联合前列地尔治疗高龄HRS患者安全有效。

Objective：To observe the clinical efficacy and toxicity of teriipressin combined with alprostadil in the treatment of hepatorenal syndrome（HRS） in the elderly patients.Method：Totally 32 elderly HRS patients were randomly divided into the control group（14 cases） and the treatment group（18 cases）.The control group was with the traditional treatment.The treatment group was treated with teriipressin and alprostadil.The clinical symptoms,urine volume,serum creatinine,urea nitrogen and toxic reactions were observed.Result：Compared with those before the therapy,urine volume of the patients was obviously increased（P 0.01）,while serum creatinine and urea nitrogen were obviously declined from the first day in the treatment group（P 0.05）.After the 7-day treatment, urine volume was further increased compared with that after the 3-day treatment（P 0.05） while the levels of serum creatinine and urea nitrogen were further decreased（P 0.05 ）.Ascites was decreased in the treatment group,while there were no obvious changes in the control group（P 0.05）.During the treatment,one case was dead in the treatment group and five cases（35.7%） were dead in the control group（P0.05）.Conclusion：Combination use of teriipressin and alprostadil is effective and safe in the treatment of HRS in elderly patients.