奥曲肽联合抗生素治疗肝硬化食管静脉曲张出血

Effects of Antibiotic and Octreotide on Liver Cirrhosis with Esophageal Variceal Bleeding

目的 观察奥曲肽联合抗生素治疗肝硬化食管静脉曲张出血 (EVB) ,探讨抗生素对奥曲肽止血效果的影响及其机理。 方法 10 0例肝硬化食管静脉曲张出血患者 ,随机分为二组 ,分别为奥曲肽和奥曲肽联合抗生素组 ,进行临床疗效的对比观察。 结果 奥曲肽组患者 6h、12h、2 4h止血率分别为 30 %、4 2 %、70 % ,奥曲肽联合抗生素组 6h、12h、2 4h止血率分别为 4 8%、72 %、94 % ,两组间比较 ,12h、2 4h止血率均存在显著差异 (P <0 .0 1) ;治疗前后患者血清一氧化氮 (NO)含量分别为 :奥曲肽组 (7.0± 0 .81) μmol/L、(6 .4 %± 0 .91) μmol/L ,奥曲肽联合抗生素组 (7.2± 0 .6 6 ) μmol/L、(5 .5± 0 .83) μmol/L(P <0 .0 1)。 结论 奥曲肽联合抗生素能显著提高肝硬化食管静脉曲张出血的止血效果 ,其机理可能与抗生素减轻肝硬化患者内毒素血症 ,降低血清NO含量有关。

Objective To observe the effects of antibiotic on treatment of cirrhosis of liver with esophageal variceal bleeding(EVB) with octreotide and investigate its mechanism.Methods one handred patients with EVB were randomly assigned to two groups.fifty patients were in the group of octreotide,fifty patients were in the group of antibiotic and octreotide.The clinical effects of the patients were observed and the serum levels of NO on patients were detected.Results The 6th、12th、24th hour hemostating rates in 50 EVB patients with octreotide treatment were 30%、42%、70%respectively,with octreotide-antibiotic treatment were 48%、72%(P<0.01)、94%(P<0.01),respectively.The serum levels of nitric oxide(NO) in two groups of EVB patients before treatment were (7.0±0.81)μmol/L,(7.2±0.66)μmol/L respectively.after treatment were(6.4±0.91)μmol/L(P<0.01)、(5.5±0.83)μmol/L(P<0.01).Conclusion Antibiotic and octreotide could increase the effect of treating EVB and its mechanism might be correlative to the serum level of NO decreased.