泮托拉唑联合生长抑素对肝硬化食管-胃底静脉曲张血流动力学及相关血清指标的影响

Effects of pantoprazole combined with somatostatin on hemodynamics of esophageal and gastric varices and serum Apri and FIB-4 in patients with liver cirrhosis

目的探究泮托拉唑联合生长抑素对肝硬化食管-胃底静脉曲张血流动力学及谷草转氨酶和血小板比率指数(aspartate aminotransferase and platelet ratio index,APRI)、肝纤维化4因子指数(factor 4 index of liver fibrosis,FIB-4)的影响。方法随机选取2019年1月至2020年11月杭州师范大学附属医院收治的100例肝硬化食管-胃底静脉曲张患者,按照随机数字表法随机分为研究组和对照组两组,每组50例。两组患者均给予吸氧、心电监护、卧床休息、建立静脉通路等处理,对伴有低血压症状的患者给予补充血容量等基本治疗。对照组患者给予泮托拉唑治疗,研究组患者在对照组的基础上给予生长抑素治疗,均连续治疗7d。对两组患者的临床资料、临床疗效、血流动力学指标、APRI、FIB-4水平及不良反应发生情况进行比较。结果与对照组比较,研究组患者住院天数明显缩短(P<0.01),治疗总有效率明显升高(P<0.05)。两组患者平均动脉压、中心静脉压、APRI、FIB-4水平治疗后均较治疗前明显升高,且研究组明显高于对照组(P<0.05);门静脉内径、门静脉血流量、心率治疗后均较治疗前明显降低,且研究组明显低于对照组(P<0.05)。两组不良反应发生率比较差异无显著性(P>0.05)。结论泮托拉唑联合生长抑素治疗肝硬化食管-胃底静脉曲张能够起到较好的临床疗效,改善患者血流动力学指标,减轻患者食管-胃底静脉曲张程度,安全可靠。

Objective To explore the effect of pantoprazole combined with somatostatin on hemodynamics,aspartate aminotransferase and platelet ratio index(Apri)and liver fibrosis factor 4 index(FIB-4)in patients with liver cirrhosis.Method 100 cases of cirrhosis patients with esophageal and gastric varices treated in Affiliated Hospital of Hangzhou Normal University from January 2019 to November 2020 were randomly divided into study group and control group according to random number table method,with 50 cases in each group.Patients in both groups were given oxygen inhalation,bed rest,venous access,close ECG monitoring and other treatment,while patients with hypotension were given basic treatment such as blood volume supplement.Patients in the control group were given pantoprazole treatment,while patients in the study group were treated with somatostatin on the basis of the control group.The two groups of patients were treated for 7 consecutive days.The clinical data,clinical efficacy,hemodynamic indexes,Apri,FIB-4 levels and adverse reactions of the two groups were compared and analyzed.Result Compared with the control group,the length of stay in the study group was significantly shorter(P<0.01),and the total effective rate was significantly increased(P<0.05).The levels of map,CVP,Apri and FIB-4 in the two groups were significantly higher than those before treatment,and those in the study group were significantly higher than those in the control group(P<0.05);the levels of PVD,PVBF and HR in the study group were significantly lower than those in the control group(P<0.05).The incidence of adverse reactions in the study group was lower than that in the control group,but there was no significant difference between the two groups(P>0.05).Conclusion Pantoprazole combined with somatostatin in the treatment of liver cirrhosis with gastric varices can play a better clinical effect,improve the hemodynamic indexes of patients,reduce the degree of gastric varices in patients with liver cirrhosis,which is safe and reliable.