白蛋白联合特利加压素治疗肝肾综合征患者的临床疗效

The clinical application of albumin combined with terlipressin in the treatment of hepatorenal syndrome

目的探讨白蛋白联合特利加压素治疗肝肾综合征患者的临床疗效。方法选取2014-2016年在延安市人民医院肾脏内科就诊的80例肝肾综合征(HRS)患者,按照患者的住院顺序,参照随机数字表,将符合标准的患者随机分为对照组和治疗组,每组患者各40例。2组患者均予以基础治疗,在此基础上对照组患者予以白蛋白静滴,治疗组患者予以白蛋白联合特利加压素治疗,治疗3w后比较两组患者体质量、腹围水平、血清肌酸酐、24h尿量、尿素氮及临床疗效情况。结果 (1)治疗结束后,治疗组患者体质量、腹围水平、血清肌酸酐、24h尿量及尿素氮均较同组治疗前有明显改善,差异具有统计学意义(P<0.05);对照组患者腹围水平及尿素氮较同组治疗前改善明显,差异具有统计学意义(P<0.05),但体质量、血清肌酐及24h尿量与治疗前比较改善不明显,差异无统计学意义(P>0.05);2组患者组间比较,治疗组患者体质量、腹围水平、血清肌酸酐、24h尿量、尿素氮等方面改善优于对照组,差异具有统计学意义(P<0.05)。(2)治疗结束时,治疗组患者总有效率为70%,对照组为32.5%,2组临床疗效比较差异具有统计学意义(χ~2=11.25,P=0.000 8),治疗组患者临床疗效优于对照组。在对不同分型HRS临床疗效比较中发现,2组Ⅰ型患者临床疗效比较差异无统计学意义(χ~2=2.60,P=0.110 0);在Ⅱ型患者中,治疗组患者临床疗效优于对照组,差异具有统计学意义(χ~2=8.52,P=0.003 5)。结论白蛋白联合特利加压素在治疗肝肾综合征患者上能够取得良好的临床疗效,尤其对于Ⅱ型患者,能够有效改善患者预后。

Objective To explore the clinical application of albumin combined with terlipressin in the treatment of hepatorenal syndrome（HRS）.Methods 80 patients with HRS who were treated with renal surgery in our hospital from 2014 to 2016 were randomly divided into control group and treatment group based on the random number table,with each group having 40 patients.Two groups of patients were treated with routine treatment,based on which patients of control group were given albumin intravenous infusion,the patients of treatment group were given with albumin combined with topoterin treatment,the two groups were treated for 3weeks,then the body weight,abdominal circumference level,Serum creatinine,urine output,urea nitrogen and clinical efficacy were compared.Results（1）After treatment,the body weight,the level of abdominal circumference,serum creatinine,24 hurine output and urea nitrogen of treatment group were significantly improved compared with before treatment（P 0.05）and the control group（P 0.05）,but no significant difference was found between the body weight,the serum creatinine and the urine output（P 0.05）.（2）At the end of treatment,the total effective rate was 70%in the treatment group and 32.5%in the control group.The difference was statistically significant（χ~2=11.25,P =0.000 8）,the patients of treatment group was shown to be better than the control group in terms of clinical efficacy.In the comparison of the clinical curative effect of different types of HRS,there was no significant difference between the two groups in the clinical curative effect of type I patients（χ~2=2.60,P =0.110 0）,The difference was statistically significant in the clinical curative effect of typeⅡ patients（χ~2=8.52,P =0.003 5）,the clinical efficacy of the treatment group was better than that of the control group.Conclusion Albumin combined with terlipressin in the treatment of liver and kidney syndrome was displayed to be able to achieve good clinical efficacy,which could effectively improve the prognosis of patients,especially for typeⅡ patients.