前列地尔联合醋酸奥曲肽治疗乙肝合并肝肾综合征的疗效及对其sIL-2R、β 2-MG水平和肾血流情况的影响

Efficacy of alprostadil combined with octreotide acetate in the treatment of hepatitis B with hepatorenal syndrome and its effects on sIL-2R,β2-MG levels and renal blood flow

目的:探讨前列地尔联合醋酸奥曲肽治疗乙肝合并肝肾综合征(HRS)的疗效及其对血清可溶性白细胞介素-2受体(sIL-2R)、β2微球蛋白(β2-MG)水平和肾血流情况的影响。方法:HRS患者86例,采用随机数字表法将其分为对照组和观察组,每组各43例,分别给予醋酸奥曲肽注射液和前列地尔注射液联合醋酸奥曲肽注射液治疗,连续治疗2周。常规检测血生化指标,采用ELISA法检测血清sIL-2R、β2-MG,采用超声检测肾血流。结果:观察组治疗有效率显著高于对照组(χ^2=4.501,P=0.034);治疗后,观察组血清血尿素氮(BUN)、肌酐(Scr)、胱抑素C(CysC)、β2-MG、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、凝血酶原活动度(PTA)、sIL-2R、NO、肿瘤坏死因子-α(TNF-α)、自动显示搏动指数(PI)、阻力指数(RI)、收缩期最高峰值(PS)、舒张期最低峰值(PD)、PS/PD显著低于对照组(P<0.05)。结论:前列地尔联合醋酸奥曲肽治疗HRS患者疗效显著,可恢复肝肾功能指标,降低血清sIL-2R、β2-MG水平,改善肾血流紊乱。

Objective:To investigate the efficacy of alprostadil combined with octreotide acetate in the treatment of hepatitis B with hepatorenal syndrome(HRS)and its effects on serum soluble interleukin-2 receptor(sIL-2R),β2 microglobulin(β2-MG)levels and renal blood flow.Methods:86 HRS patients were divided into control group and observation group by random number table,43 cases in each group.They were given octreotide acetate injection and alprostadil injection combined with octreotide acetate injection,respectively.The treatment was treatment continuously for 2 weeks.Blood biochemical indicators were routinely tested,serum sIL-2R andβ2-MG were detected by ELISA,and renal blood flow was detected by ultrasound.Results:The effective rate of the observation group was significantly higher than that of the control group(χ^2=4.501,P=0.034).After treatment,the serum urea nitrogen(BUN),creatinine(Scr),Cystatin C(CysC),β2-MG,alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),prothrombin activity(PTA),sIL-2R,NO,tumor necrosis factor-α(TNF-α),automatic display of pulsatility index(PI),resistance index(RI),and blood pressure were measured The peak systolic(PS),lowest diastolic peak(PD)and PS/PD were significantly lower than those in the control group(P<0.05).Conclusion:Alprostadil combined with octreotide acetate has a significant effect on patients with HRS,can restore liver and kidney function indexes,reduce serum sIL-2R andβ2-MG levels,and improve renal blood flow disorders.