人血白蛋白联合呋塞米治疗老年肝硬化腹水临床效果及对PRA、GFR、MAP影响研究

Clinical Effect of Human Serum Albumin Combined with Furosemide on Senile Cirrhotic Ascites and its Effect on PRA,GFR and MAP

目的:探讨老年肝硬化腹水患者采用人血白蛋白联合呋塞米的临床效果及对血浆肾素活性(PRA)、肾小球滤过率(GFR)、平均动脉压(MAP)的影响。方法:选取2018年12月至2019年12月新乡市传染病医院收治的老年肝硬化腹水患者106例作为研究对象,随机数字表法分为观察组(n=53)与对照组(n=53),均接受常规治疗,同时给予对照组呋塞米治疗,给予观察组人血白蛋白联合呋塞米治疗。比较两组临床疗效、治疗前后相关指标(腹水消退时间、24 h尿量),血清指标[血浆肾素活性(PRA)、肾小球滤过率(GFR)、平均动脉压(MAP)],不良反应发生率。结果:观察组总有效率88.68%高于对照组62.26%(P<0.05);治疗前,两组24 h尿量及PRA、GFR、MAP水平相比差异无统计学意义(P>0.05),治疗4周后两组24 h尿量高于治疗前,且观察组(3 987.12±512.11)mL高于对照组(2 436.58±347.12)mL,观察组腹水消退时间(14.25±2.10)d短于对照组的(21.14±3.58)d(P<0.05);两组PRA、GFR、MAP水平优于治疗前,且观察组PRA水平(11.58±4.10)ng/mL低于对照组(18.96±4.78)ng/mL,GFR、MAP水平分别为(105.32±32.10)mL/min、(77.85±4.36)mm Hg,高于对照组的(93.25±26.24)mL/min、(74.10±4.12)mm Hg(P<0.05);观察组不良反应发生率9.43%与对照组7.55%相比差异无统计学意义(P>0.05)。结论:人血白蛋白联合呋塞米能提高老年肝硬化腹水患者临床疗效,增加排尿量,缩短腹水消退时间,改善血流动力学,减轻肾功能损害及减退。

Objective:To investigate the clinical efficacy of human albumin combined with furosemide in senile cirrhotic ascites patients and its effects on plasma renin activity (PRA) and Glomerular filtration rate (GFR) and Mean Arterial pressure (MAP).Methods:A total of 106 elderly patients with cirrhotic ascites admitted to Xinxiang Infectious Disease Hospital from December 2018 to December 2019 were selected as the research objects.They were divided into observation group (n=53) and control group (n=53) by random number table method.All of them received conventional treatment,while furosemide was given to the control group.The observation group was treated with human albumin combined with furosemide.The clinical efficacy,related indexes before and after treatment (ascites regression time,24 h urine volume),serum indexes PRA,GFR,MAP and incidence of adverse reactions were compared between 2 groups.Results:The total effective rate of observation group was 88.68% higher than that of control group 62.26% (P0.05).After 4 weeks of treatment,24 h urine volume in the two groups was higher than that before treatment,and the observation group (3 987.12±512.11) mL was higher than the control group (2 436.58±347.12) mL.The ascites regression time of observation group (14.25±2.10) d was shorter than that of control group (21.14±3.58) d (P0.05).Conclusion:Human serum albumin combined with furosemide can improve the clinical efficacy of senile cirrhotic ascites patients,increase the volume of urine,shorten the time of ascites regression,improve hemodynamics,and reduce renal impairment.