奥曲肽联合前列地尔治疗肝硬化合并肝肾综合征的疗效

Octreotide combined with alprostadil for treatment of cirrhosis with hepatorenal syndrome

目的:观察和评价奥曲肽联合前列地尔治疗肝硬化合并肝肾综合征(hepatorenal syndrome,HRS)的疗效.方法:选取78例肝硬化合并肝肾综合征患者,将其随机分为观察组和对照组,其中观察组患者共计有40例,对照组患者共计有38例,在进行白蛋白输注、营养支持、血管加压素、保肝等常规治疗的前提下,观察组患者使用奥曲肽联合前列地尔进行治疗,对照组仅使用前列地尔进行治疗.在经过有效的治疗之后,对两组患者的肝肾功能指标、腹水减少情况以及临床症状进行观察和对比.结果:在观察组当中有14例显效,占患者总数的35.0%,有19例患者有效,占患者总数的47.5%,有7例患者无效,占患者总数的17.5%,总有效率达82.5%;而对照组患者当中有10例显效、占患者总数的26.3%,有12例患者显效,占患者总数的31.6%,有16例患者无效,占患者总数的42.1%,总有效率达57.9%.相对于对照组的有效率而言,观察组患者的总有效率明显要高,差异具有统计学意义(P<0.05).相对于对照组的有效率而言,观察组患者的前后肝肾功能变化差异显著,具有统计学意义(P<0.05).结论:奥曲肽联合前列地尔治疗肝硬化合并肝肾综合征具有良好的效果.

AIM： To evaluate the efficacy of octreotide combined with alprostadil in the treatment of cirrho-sis with hepatorenal syndrome（HRS）. METHODS： Seventy-eight cirrhotic patients with HRS were randomly divided into two groups： a control group（n = 38） and an observation group（n = 40）. On the basis of albumin infusion, nutrition support and other conventional therapies, the observation group was given octreotide and alprostadil, and the control group was given alprostadil only. After treatment, liver and kid-ney function indicators and clinical symptoms were observed and compared between the two groups.RESULTS： In the observation group, 14（35.0%） cases showed significant improvement, 19（47.5%） cases showed moderate improvement, and 7（17.5%） cases showed no improvement; the corresponding figures in the control group were 10（26.3%）, 12（31.6%） and 16（42.1%）, respectively. The total response rate in the observation group was significantly higher than that in the control group（82.5% vs 57.9%, P〈0.05）. In addition, liver and kidney function indicators in the observation group showed significant improvement compared with the control group（P〈0.05）.CONCLUSION： Octreotide combined with al-prostadil is effective in the treatment of cirrhosis with HRS.