生长抑素联合奥曲肽治疗对肝硬化合并上消化道出血患者肝静脉压及血清凝血功能指标水平的影响

Effects of somatostatin combined with octreotide on hepatic venous pressure and serum coagulation function indexes in patients with cirrhosis complicated with upper gastrointestinal bleeding

目的探讨生长抑素联合奥曲肽治疗对肝硬化合并上消化道出血患者肝静脉压及血清凝血功能指标水平的影响。方法选取2019年6月至2022年7月鹰潭市人民医院收治的70例肝硬化合并上消化道出血患者作为研究对象,采用随机数字表法分为对照组与研究组,每组35例。对照组给予奥曲肽治疗,研究组给予生长抑素联合奥曲肽治疗,比较两组肝静脉压指标、凝血功能指标、肝功能指标、血流动力学指标、药物不良反应及健康状况评分。结果治疗后,两组肝静脉游离压(free hepatic vein pressure,FHVP)、肝静脉楔压(wedged hepatic vein pressure,WHVP)及肝静脉压力梯度(hepatic venous pressure gradient,HVPG)均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组凝血酶原时间(prothrombin time,PT)、凝血酶时间(thrombin time,TT)均短于治疗前,纤维蛋白原(fibrinogen,Fg)水平均高于治疗前,且研究组PT、TT均短于对照组,Fg水平高于对照组,差异有统计学意义(P<0.05)。治疗后,两组总胆红素(total bilirubin,TBIL)、谷草转氨酶(aspartate transaminase,AST)、谷丙转氨酶(alanine transaminase,AIL)水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组门静脉血流量、脾静脉血流量均少于治疗前,且研究组少于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。治疗后,两组生理功能、生理职能、精神健康、生命活力、躯体疼痛、社会功能、情感职能、总体健康评分均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05)。结论生长抑素联合奥曲肽治疗可有效改善肝硬化合并上消化道出血患者肝静脉压、凝血功能及肝功能,且安全性较高,值得临床推广应用。

Objective To investigate the effects of somatostatin combined with octreotide on hepatic venous pressure and serum coagulation function indexes in patients with cirrhosis complicated with upper gastrointestinal bleeding.Methods 70 patients with cirrhosis complicated with upper gastrointestinal bleeding treated in Yingtan People's Hospital from June 2019 to July 2022 were selected as the research subjects,and they were divided into the control group and the study group according to the random number table method,with 35 cases in each group.The control group was treated with octreotide,while the study group was treated with somatostatin combined with octreotide,the indexes of hepatic venous pressure,coagulation function,liver function,hemodynamics,adverse drug reactions and health status scores were compared between the two groups.Results After treatment,the free hepatic vein pressure(FHVP),wedged hepatic vein pressure(WHVP)and hepatic venous pressure gradient(HVPG)of the two groups were lower than before treatment,and the study group was lower than the control group,and the differences were statistically significant(P<0.05).After treatment,the prothrombin time(PT)and thrombin time(TT)of the two groups were shorter than before treatment,and the fibrinogen(Fg)level was higher than before treatment,and the PT and TT in the study group were shorter than that in the control group,and the Fg level was higher than that in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of total bilirubin(TBIL),aspartate aminotransferase(AST)and alanine aminotransferase(AIL)of the two groups were lower than before treatment,and the study group was lower than the control group,and the differences were statistically significant(P<0.05).After treatment,portal vein blood flow and splenic vein blood flow of the two groups were lower than before treatment,and the study group was lower than the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.After treatment,the physiological function,physiological function,mental health,vital vitality,physical pain,social function,emotional function and overall health scores of the two groups were higher than before treatment,and the study group was higher than the control group,the differences were sta-tistically significant(P<0.05).Conclusion Somatostatin combined with octreotide can effectively improve the hepatic venous pressure,coagulation function and liver function in patients with cirrhosis complicated with upper gastrointestinal bleeding,and it is safe and worthy of clinical promotion and application.