垂体后叶素联合生长抑素治疗肝硬化上消化道出血的有效性及安全性

Efficacy and safety of pituitrin combined with somatostatin in the treatment of upper gastrointestinal bleeding caused by cirrhosis

目的研究垂体后叶素联合生长抑素治疗肝硬化上消化道出血的有效性及安全性。方法选取2021年1月至2022年1月我院收治的100例肝硬化上消化道出血患者为研究对象,以随机数字表法将其分为对照组和观察组,各50例。对照组采用生长抑素治疗,观察组采用垂体后叶素联合生长抑素治疗。比较两组的临床疗效、实验室指标及不良反应发生情况。结果观察组的治疗总有效率为96.00%,高于对照组的84.00%,差异具有统计学意义(P<0.05)。治疗后,观察组的纤维蛋白原(Fib)、D-二聚体(D-D)水平高于对照组,凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)短于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的全血高切黏度、全血低切黏度及血浆黏度高于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的内皮素-1(ET-1)、一氧化氮(NO)水平低于对照组,差异具有统计学意义(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论垂体后叶素联合生长抑素治疗肝硬化上消化道出血的效果显著,不仅可改善凝血功能及血液流变学,还能降低血管活性因子水平,且用药安全性高。

Objective To study the efficacy and safety of pituitrin combined with somatostatin in the treatment of upper gastrointestinal bleeding caused by cirrhosis.Methods A total of 100 patients with upper gastrointestinal bleeding caused by cirrhosis admitted in our hospital from January 2021 to January 2022 were selected as the research objects.The patients were divided into control group and observation group by random number table method,with 50 cases in each group.The control group was treated with somatostatin,and the observation group was treated with pituitrin combined with somatostatin.The clinical efficacy,laboratory indexes and adverse reactions were compared between the two groups.Results The total effective rate of treatment in the observation group was 96.00%,which was higher than 84.00%in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of fibrinogen(Fib)and D-dimer(D-D)in the observation group were higher than those in the control group,the prothrombin time(PT)and activated partial thromboplastin time(APTT)were shorter than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the whole blood high shear viscosity,whole blood low shear viscosity and plasma viscosity in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of endothelin-1(ET-1)and nitric oxide(NO)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Pituitrin combined with somatostatin is effective in the treatment of upper gastrointestinal bleeding caused by cirrhosis.It can not only improve coagulation function and hemorheology,but also reduce the level of vasoactive factors,and has high safety.