垂体后叶素联合生长抑素治疗肝硬化上消化道出血的临床疗效及安全性观察

Clinical Effects and Safety of Hypophysin and Somatostatin on the Treatment of Liver Cirrhosis and Upper Gastrointestinal Hemorrhage

目的 研究垂体后叶素+生长抑素在肝硬化上消化道出血中的价值。方法 将2020年5月至2022年5月平顶山市第一人民医院纳入的80例肝硬化上消化道出血患者,通过随机列表法进行分组,各组40例,研究组使用垂体后叶素+生长抑素,对照组采取垂体后叶素,比较各组有效率、凝血功能、炎性指标、肝功能、止血时长、住院天数、不良反应及生活质量(GQOLI-74)评分、免疫指标。结果 研究组有效率(92.50%)高于对照组(75.00%),差异有统计学意义(P<0.05)。研究组止血时长、住院天数均短于对照组,差异有统计学意义(P<0.05)。研究组不良反应发生率(12.50%)与对照组(7.50%)比较,差异无统计学意义(P>0.05)。用药前,各组凝血功能、炎性指标、肝功能、GQOLI-74评分、免疫指标差异无统计学意义(P>0.05);用药后,研究组凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、肾素活性(PRA)、血管活性肠肽(VIP)、血管紧张素II(Ang Ⅱ)、白蛋白(ALB)、丙氨酸氨基转移酶(ALT)、总胆红素(TBiL)、天门冬氨酸氨基转移酶(AST)、免疫球蛋白IgE、IgG、IgA低于对照组,但二聚体(D-D)、纤维蛋白原(Fib)、GQOLI-74评分高于对照组,差异有统计学意义(P<0.05)。结论 垂体后叶素+生长抑素的效果更为理想,可有效改善患者凝血功能及肝功能,同时减轻炎性反应,缩短住院天数,不良反应较少,安全性较高,提升患者生活质量,调节机体免疫。

Objective To study the clinical value of hypophysin and somatostatin on the treatment of liver cirrhosis and upper gastrointestinal hemorrhage.Methods A total of 80 liver cirrhosis patients with upper gastrointestinal hemorrhage treated from May 2020 to May 2022 in Pingdingshan First People’s Hospital were selected.According to random listing method,patients were assigned to study group(N=40,hypophysin and somatostatin)and control group(N=40,hypophysin).Response rate,coagulation function,inflammatory indicators,liver function,hemostatic duration,hospitalization days,adverse reactions and quality of life(GQOLI-74)scores,and immune index were compared between two groups.Results The total effective rate of the study group(92.50%)was higher than that of control group(75.00%),with significant difference(P<0.05).The hemostasis time and hospitalization days in the study group were shorter than those in the control group,with significant differences(P<0.05).There was no significant difference about the adverse reactions in the study group(12.50%)and control group(7.50%)(P>0.05).Before treatment,there were no significant differences about the coagulation function,inflammatory factors,liver function,GQOLI-74 score and immune indexes(P>0.05);After treatment,the prothrombin time(PT),activated partial prothrombin time(APTT),plasma renin activity(PRA),vasoactive intestinal peptide(VIP),angiotensinⅡ(AngⅡ),albumin(ALB),Alanine aminotransferase(ALT),total bilirubin(TBiL),Aspartate transaminase(AST),immunoglobulin IgE,IgG and IgA values in the study group were lower than those in the control group;but D-dimer(D-D),fibrinogen(Fib)and GQOLI-74 scores were higher than those in the control group,with significant differences(P<0.05).Conclusion The effect of hypophysin combined with somatostatin is more ideal,which can effectively improve the coagulation function and liver function of patients,reduce the inflammatory reaction,shorten the number of hospital stay,have fewer adverse reactions,high safety,improve the quality of life of patients,and regulate the body immunity.