奥曲肽治疗肝肾综合征的疗效观察

Observation of the Efficacy of Octreotide for the Treatment of Hepatorenal Syndrome

【目的】探讨奥曲肽治疗肝肾综合征（HRS）的临床疗效。【方法】将48例HRS患者随机分为两组，对照组23例，给予白蛋白和呋塞米及其他护肝等综合治疗，治疗组25例，在对照组基础上给予奥曲肽治疗，比较两组患者的疗效及治疗前后血肌酐、尿素氮、24h尿量、门静脉及脾静脉内径、血流动力学的变化。【结果】治疗组总有效率80％显著高于对照组43．5％（P〈0．05）；治疗组血肌酐、尿素氮水平较对照组显著降低，尿量较对照组显著增加，门静脉及脾静脉内径较治疗前明显缩小，其差异均有统计学意义（均P〈0．05），血流动力学两组比较无显著性差异（P〉0．05）。【结论】在白蛋白、呋塞米及护肝治疗的基础上加用奥曲肽治疗HRs可降低患者血肌酐、尿素氮水平，增加尿量，减小门静脉压力且对血流动力学无影响，是一种简单、有效的治疗方法。

[Objective] To explore the clinical efficacy of octreotide for the treatment of hepatorenal syn- drome（HRS）. [Methods] A total of 48 patients with HRS were randomly divided into two groups. The con- trol group（ n =23） was given combination therapy including albumin, furosemide and other liver protection drugs. The treatment group（ n = 25） was given octreotide based on the treatment of control group. The effica- cy, serum creatinine（Cr）, urea nitrogen（BUN）, 24h urine volume, diameter of portal and splenic vein and he- modynamic changes before and after treatment were compared between two groups. [Results] The total effec- tive rate of treatment group was 80%, which was markedly higher than that in control group（43.5%）（ P 〈0.05）. Compared with control group, serum Cr and BUN in treatment group decreased markedly, while urine volume increased markedly. Compared with before treatment, the diameter of portal veins and splenic veins obviously decreased after treatment, and there was significant difference（ P 〈0.05）. There was no significant difference in hemodynamics between two groups （ P 〉0.05）. [Conclusion]Based on the treatment with albu- min, furosemide and liver protection drug, octreotide for the treatment of HRS can reduce the level of serum Cr and BUN, increase urine volume, decrease portal vein pressure, and has no influence on hemodynamics. Therefore, it is a simple and effective treatment method.