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您现在的位置:首页 => 在线期刊 => 2015年 2期 自身免疫性肝病 => 肝纤维化及肝硬化 =>奥曲肽和特利加压素单用或联用对肝..
奥曲肽和特利加压素单用或联用对肝硬化患者肝静脉压力梯度的影响
Individual and combined effects of octreotide and terlipressin on hepatic venous pressure gradient in cirrhotic patients
文章发布日期:2015年02月13日  来源:  作者:夏玉莲, 张春清, 王广川,等  点击次数:2182次  下载次数:725次

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【摘要】:目的分别观察奥曲肽和特利加压素单用及二者联合对肝静脉压力梯度(HVPG)的影响。方法收集2011年1月-2014年4月山东大学附属省立医院消化科住院的肝硬化并静脉曲张患者49例,将患者分成奥曲肽组(A组)、特利加压素组(B组)、联合用药组(C组)。A组:奥曲肽0.1 mg静推(给药时间1 min),继以25 μg/h泵入,分别测给药前及给药后1、5、10和15 min时的HVPG;B组:特利加压素1 mg静推(2 min内完成),分别测给药前及给药后10、20和30 min时的HVPG;C组:首先给予奥曲肽,分别测奥曲肽给药前及给药后1、5、10和15 min的HVPG,继以联合特利加压素静推,分别测定联合特利加压素后10、20和30 min时的HVPG。采用t检验、方差分析和卡方检验对数据进行统计学分析。结果A组奥曲肽给药后15、10和15 min HVPG显著下降(t值分别为13.173、5.364、3.894、4160,P值均<0.001),但5、10和15 min之间差异无统计学意义(P值均>005)。B组特利加压素给药20 min后HVPG显著下降(t=4.062,P=0.002),20和30 min HVPG之间差异有统计学意义(t=4.022,P=0.002)。C组加用特利加压素20 min后HVPG进一步下降(t=4.926, P<0.001),20和30 min HVPG之间差异无统计学意义(t=1.733,P=0101)。三组疗效差异有统计学意义,C组疗效明显大于A、B组(F=10.423,P<0.05)。结论奥曲肽能很快降低肝硬化门静脉高压患者的HVPG,但短期内有所回升且趋于稳定。特利加压素单独应用亦能降低HVPG,起效时间比奥曲肽慢。奥曲肽加用特利加压素后可进一步降低HVPG,效果优于单独用药。
【Abstract】:ObjectiveThe administration of octreotide, as well as terlipressin, is a routine treatment for acute variceal bleeding in cirrhotic patients. This study aimed to evaluate the effects of octreotide, terlipressin, and their combination on hepatic venous pressure gradient (HVPG) in cirrhotic patients. MethodsThe study enrolled 49 cirrhotic patients with varicose veins who were hospitalized at the Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University during January 2011 to April 2014. The patients were divided into three groups: group A (octreotide alone), group B (terlipressin alone), and group C (the combination). Group A: Octreotide was administered via intravenous injection of 1.0 mg within 1 min followed by intravenous pumping at 25 μg/h, and HVPG was measured before drug administration and at 1, 5, 10, and 15 min after the start of octreotide injection. Group B: Terlipressin was administered by intravenous injection of 1 mg within 2 min, and HVPG was measured before drug administration and at 10, 20, and 30 min after the start of terlipressin injection. Group C: First, octreotide was administered and HVPG was measured as performed for group A; then, terlipressin was given and HVPG was measured as performed for group B. Data were statistically analyzed using the t test, analysis of variance, and chi-square test. ResultsIn group A, HVPG was significantly decreased at different time points after octreotide injection (t=13173, P<0.001; t=5.364, P<0.001; t=3.894, P=0.001; t=4.160, P<0.001), but no significant differences were found between 5, 10, and 15 min (all P>0.05). In group B, HVPG was significantly decreased at 20 min after terlipressin injection (t=4.062, P=0.002),with significant difference between 20 and 30 min (t=4.022, P=0.002). In group C, HVPG was further decreased at 20 min after terlipressin injection (t=4.926, P<0.001), with no significant difference between 20 and 30 min (t=1.733, P=0.101). A better effect was achieved in group C than in groups A and B (F=10.423, P<0.05). ConclusionContinuous octreotide injection rapidly reduces HVPG in cirrhotic patients with portal hypertension, but HVPG gradually increases to a stable level in a short period. Terlipressin injection also reduces HVPG but works more slowly than octreotide. Terlipressin injection after octreotide further reduces HVPG, indicating a better combined effect of the drugs than individual ones.
【关键字】:肝硬化;奥曲肽;特利加压素;肝静脉
【Key words】:liver cirrhosis; octreotide; terlipressin; hepatic veins
【引证本文】:

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