前列地尔治疗乙型肝炎肝硬化并发肾损伤疗效观察

Therapeutic effect of alprostadil on hepatitis B cirrhosis complicated with renal injury

目的观察前列地尔治疗乙型肝炎肝硬化并发肾损伤的临床疗效。方法将110例乙型肝炎肝硬化患者随机分为观察组和对照组,对照组给予传统综合治疗,包括一般治疗、支持治疗及护肝治疗,观察组在此基础上给予前列地尔注射液10μg静滴,1次/d,疗程均为21 d。观察2组治疗前后肝功能指标[丙氨酸氨基转移酶(ALT)、总胆红素(TBil)、白蛋白(ALB)、凝血酶原活动度(PTA)]及肾功能指标[血肌酐(SCr)、尿素氮(BUN)、胱抑素C(CysC)]水平。结果治疗后2组患者ALT、TBil水平均较治疗前明显降低(P均<0.05),ALB、PTA水平均较治疗前明显升高(P均<0.05),且治疗后观察组ALT、TBil水平均明显低于对照组(P<0.05),而2组间ALB、PTA比较差异均无统计学意义(P均>0.05)。治疗后2组患者SCr、BUN、CysC水平均较治疗前明显降低(P均<0.05),且观察组改善程度明显优于对照组(P<0.05)。治疗过程中,观察组仅10例出现轻微不良反应,均经减慢滴速后症状自行消失或减轻,未影响疗程。结论前列地尔是一种具有肝肾同治效果的药物,在乙型肝炎肝硬化并发肾损伤的治疗中能明显改善肝肾功能,效果显著。

Objective It is to observe the clinical efficacy of alprostadil in the treatment of hepatitis B cirrhosis complicated with renal injury. Methods 110 patients with hepatitis B cirrhosis were randomly divided into observation group and control group. The control group received traditional comprehensive treatment including general treatment, supportive treatment and liver protection treatment. The observation group was given 10 μg of alprostadil injection by intravenous drip, 1 time/d. Both groups were treated for 21 days. The levels of liver function indexes [alanine aminotransferase(ALT), total bilirubin(TBil), albumin(ALB), prothrombin activity(PTA)] and renal function indicators [serum creatinine(SCr), urea nitrogen(BUN), and cystatin C(CysC)] were detected before and after treatment in the two groups. Results After treatment, the levels of ALT and TBil in the two groups were significantly lower while that of ALB and PTA were significantly higher than those before treatment(P<0.05), and the levels of ALT and TBil in the observation group were significantly lower than those in the control group(P<0.05), there was no significant difference in ALB and PTA between the two groups(P>0.05). The levels of SCr, BUN and CysC in the two groups were significantly lower than those before treatment in the two groups(P<0.05), and the improvements in the observation group were significantly better than that in the control group(P<0.05). During the treatment, only 10 cases of mild adverse reactions occurred in the observation group, and the symptoms disappeared or decreased spontaneously after slowing down the drip rate, which did not affect the course of treatment. Conclusion Alprostadil is a drug which could treat for both liver and kidney. It can significantly improve liver and kidney function in the treatment of hepatitis B cirrhosis complicated with renal injury.