醋酸奥曲肽联合前列地尔对乙肝肝硬化合并肝肾综合征患者血清炎性因子的影响

Effect of octreotide acetate combined with alprostadil on serum inflammatory factors of hepatitis B cirrhosis patients complicated with hepatorenal syndrome

目的探讨醋酸奥曲肽联合前列地尔对乙肝肝硬化合并肝肾综合征患者血清炎性因子的影响。方法选取乙肝肝硬化合并肝肾综合征患者92例,随机分为2组。前列地尔组在常规治疗的基础上使用前列地尔注射液静脉滴注,联合组在前列地尔组的基础上使用醋酸奥曲肽注射液皮下注射,2组患者均治疗2周。比较2组患者治疗前后血清炎性因子指标[肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)和超敏C反应蛋白(hs-CRP)]、肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)、凝血酶原活动度(PTA)和总胆红素(Tbil)]、肾功能指标[尿素氮(BUN)、血肌酐(SCR)]以及24 h尿量的变化。结果治疗后,2组患者的TNF-α、IL-6和hs-CRP含量均显著低于治疗前,且联合组上述指标显著低于前列地尔组(P <0. 05)。治疗后,2组患者的肝功能指标均显著改善,且联合组的ALT、AST和Tbil含量显著低于前列地尔组,PTA显著高于前列地尔组(P <0. 05)。治疗后,2组患者的肾功能指标和24 h尿量均显著改善,且联合组的BUN、SCR含量显著低于前列地尔组,24 h尿量显著高于前列地尔组(P <0. 05)。治疗后,联合组的治疗总有效率显著高于前列地尔组(P <0. 05)。结论醋酸奥曲肽联合前列地尔能够有效地降低乙肝肝硬化合并肝肾综合征患者血清炎性因子水平,改善肝肾功能,提高治疗有效率。

Objective The explore the effect of octreotide acetate combined with alprostadil on serum inflammatory factors of hepatitis B cirrhosis patients complicated with hepatorenal syndrome. Methods Totally 92 hepatitis B cirrhosis patients complicated with hepatorenal syndrome were selected and randomly divided into two groups. Alprostadil group was treated with intravenous injection of alprostadil on the basis of routine treatment, while the combination group was subcutaneously injected with octreotide acetate injection based on the alprostadil group. Both groups were treated with 2 weeks. Before and after treatment, the changes of serum inflammatory cytokines （TNF-α, IL-6 and hs-CRP）, liver function indicators （ALT, AST, PTA and Tbil）, renal function indexes （BUN and SCR）, and 24 h urine volume were compared between two groups. Results After treatment, the levels of TNF-α, IL-6 and hs-CRP in both groups were significantly lower than before treatment, and the levels of indexes above in the combination group were significantly than the alprostadil group （ P 〈0.05）. After treatment, liver function indicators were significantly improved in both groups, and the ALT, AST, and Tbil levels in the combination group were significantly lower than those in the alprostadil group, while PTA was significantly higher than that in the alprostadil group （ P 〈0.05）. After treatment, the renal function indexes and 24 h urine output were significantly improved in both groups, and the BUN and SCR levels in the combination group were significantly lower than those in the alprostadil group, while the 24 h urine volume was significantly higher than that in the alprostadil group （ P 〈0.05）. After treatment, the total effective rate of the combined group was significantly higher than that of the alprostadil group （ P 〈0.05）. Conclusion Octreotide acetate combined with alprostadil can effectively reduce the serum levels of inflammatory factors in hepatitis B cirrhosis patients with hepatorenal syndrome, improve liver and kidney functions, and increase therapeutic efficiency.