前列地尔对2型肝肾综合征患者肾血流、血管活性物质的影响

Effect of alprostadil on renal hemodynamics and vasoactive substance in patients with type 2 hepatorenal syndrome

目的评价前列地尔对2型肝肾综合征(HRS)患者肾血流、血管活性物质的影响。方法入选86例2型肝肾综合征患者并随机分成试验组和对照组,各43例,对照组给予保肝、护肾、利尿等常规治疗;试验组在对照组基础上给予前列地尔注射液10μg,加入0.9%氯化钠注射液中,每日1次,2组疗程均为2周。比较2组治疗前后肾血流、血管活性物质及肝肾功能指标。结果治疗后,试验组搏动指数、阻力指数、收缩期最高峰值、舒张期最低峰值、一氧化氮、肾素、内皮素、谷丙转氨酶、总胆红素、血肌酸酐及尿素氮均低于对照组(P<0.05);试验组内生肌酐清除率显著高于对照组(P<0.05)。结论前列地尔可有效改善2型肝肾综合征患者肾血流和血管活性物质水平,提高临床疗效。

Objective To explore the effect of alprostadil on renal hemodynamics and vasoactive substance in patients with type 2 hepato-renal syndrome （ HRS ） .Methods Eighty -six patients with type 2 hepatorenal syndrome were randomly divided into the observation group （ n=43 ） and the control group（ n=43）.They all accepted the conventional treatment , but the patients in the observation group were given the treatment of alprostadil injection 10 μg put into 0.9% NaCl injection once a day. The treatment lasted for 2 weeks.The data of renal hemodynamics and vasoactive substance were compared between the two group after 2 weeks. Results After treatment, the data of leak diastolic velocity, resistive index, peak systolic velocity, pulsatile index, the renin, endothelin, nitric oxide, glutamic pyruvic transaminase, total bilirubin, and creatinine and urea nitrogen in the observation group were significantly lower than those in the control group （ P〈0.05 ） , and the endogenous creatinine clearance rate were significantly higher than that in the control group （ P〈0.05 ） .Conclusion Alprostadil could improve the clinical efficacy by improving renal hemodynamics and vasoactive substance in patients with type 2 hepatorenal syndrome.