奥曲肽辅助特利加压素治疗失代偿期肝硬化并发肝肾综合征患者疗效分析

Short-term efficacy of terlipressin and octreotide combination in treatment of cirrhotic patients complicated by hepatorenal syndrome

目的探讨应用奥曲肽辅助特利加压素治疗失代偿期肝硬化并发肝肾综合征(HRS)患者的疗效。方法我院消化内科收治的失代偿期肝硬化并发HRS患者66例,随机分为观察组33例和对照组33例,分别给予特利加压素或者特利加压素联合奥曲肽治疗1周,观察近期疗效。结果治疗后,观察组体质量、腹围和24 h尿量分别为(52.6±4.7)kg、(89.6±6.5)cm和(1213.6±489.4)ml/24 h,与对照组的【(57.3±4.8)kg、(95.5±7.8)cm和(747.5±310.9)ml/24 h】比,差异显著(P<0.01);观察组血清TBIL和Alb分别为((14.6±16.5)μmol/L和(34.5±3.4)g/L,与对照组的【(20.5±19.4)μmol/L和(29.5±3.1)g/L】比,差异显著(P<0.01);观察组血BUN和Na+分别为(11.6±2.3)mmol/L和(133.4±5.3)mmol/L,与对照组的【(15.4±4.3)mmol/L和(127.4±4.7)mmol/L】比,差异显著(P<0.01);治疗前后两组门静脉内径、脾静脉内径和脾厚度变化差异无统计学意义(P>0.01)。结论应用奥曲肽辅助特利加压素治疗失代偿期肝硬化并发HRS患者能短期增加尿量,缩小腹围,可能与改善了肾功能有关。

Objective The purpose of this study was to investigate the short-term efficacy of terlipressin and octreotide combination in treatment of decompensated cirrhotic patients complicated by hepatorenal syndrome(HRS).Methods A total of 66 patients with decompensated cirrhosis and HRS were enrolled in this study,and were randomly divided into combination and control groups with 33 cases in each.The patients received combination of terlipressin and octreotide or terlipressin alone therapy for one week.Results At the end of the regimen,the body mass,abdominal circumference and urine volume in patients with combination therapy were(52.6±4.7)kg,(89.6±6.5)cm and(1213.6±489.4)ml/24 h,significantly different as compared to【(57.3±4.8)kg,(95.5±7.8)cm and(747.5±310.9)ml/24 h】in the control(P<0.01);serum bilirubin and albumin levels in combination group were(14.6±16.5)μmol/L and(34.5±3.4)g/L,significantly different as compared to【(20.5±19.4)μmol/L and(29.5±3.1)g/L】in the control(P<0.01);blood urea nitrogen and Na+levels in combination group were(11.6±2.3)mmol/L and(133.4±5.3)mmol/L,significantly different as compared to【(15.4±4.3)mmol/L and(127.4±4.7)mmol/L】in the control(P<0.01);the changes of portal vein and splenic vein diameters as well as the thickness of spleens in the two group before and after the treatment weren’t significantly different(P>0.01).Conclusion The administration of terlipressin and octreotide might help subside ascites,increase urine volumes,and improve the short-term quality of life in patients with decompensated liver cirrhosis and HRS.