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特利加压素治疗Ⅱ型肝肾综合征的临床疗效观察
Clinical efficacy of terlipressin in treatment of type II hepatorenal syndrome
文章发布日期:2015年04月15日  来源:  作者:丁晓红,顾建英  点击次数:1456次  下载次数:284次

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【摘要】:目的观察国产特利加压素治疗Ⅱ型肝肾综合征(HRS)的疗效。方法选取2011年11月-2014年6月上海市浦东新区南华医院收治的25例Ⅱ型HRS患者作为治疗组,2011年前用多巴胺治疗的28例Ⅱ型HRS患者作为对照组。治疗组随机分成两组,其中一组(12例)每8 h给药1次,另一组(13例)每12 h给药1次。两组给药前均予以白蛋白(Alb)扩容,疗程均为7 d。观察两组患者治疗前后症状改善情况,尿素氮、血清肌酐、电解质、尿量、肝功能变化及腹水消退情况。计数资料组间比较采用χ2检验,计量资料组间比较采用t检验。结果对照组患者症状改善不明显,治疗组患者症状均得到不同程度的改善。两组患者治疗前后肝功能、血清钠均无明显变化。治疗组患者腹水从大量减为中等量的病例数明显多于对照组,两组比较差异有统计学意义(χ2=5.705,P<0.05)。对照组多巴胺治疗后尿素氮、血肌酐与治疗前比较,有一定程度的改善,但差异无统计学意义(P值均>0.05),尿量治疗前后比较差异有统计学意义(t=15.534,P<0.01)。治疗组用特利加压素治疗前后尿素氮、血肌酐、尿量比较,差异均具有统计学意义(t值分别为11.535、9.941、19.685,P值均<0.01);两组治疗后比较尿素氮、血肌酐、尿量变化,差异均具有统计学意义(t值分别为7.317、9.284、9.839,P值均<0.01)。治疗组特利加压素每8 h给药1次比每12 h给药1次尿素氮、血肌酐、尿量改善更明显,但治疗后两组比较差异均无统计学意义(P值均>0.05)。特利加压素不良反应轻微,患者基本能耐受。 结论国产特利加压素联合Alb治疗Ⅱ型HRS疗效明显,不良反应小,值得临床推广。
【Abstract】:ObjectiveTo investigate the clinical efficacy of domestic terlipressin in the treatment of type II hepatorenal syndrome (HRS-II). MethodsA total of 25 HRS-II patients admitted to our hospital from November 2011 to June 2014 were recruited into the treatment group, and 28 HRS-II patients treated with dopamine before 2011 were recruited into the control group. Patients in the treatment group were randomly divided into two subgroups: one subgroup (n=12) was given terlipressin once every 8 h, and the other subgroup (n=13) was given terlipressin once every 12 h. Both groups received albumin (Alb) infusion to expand the blood volume before treatment with terlipressin or dopamine, and the course of treatment was 7 days. The improvement in clinical symptoms, levels of blood urea nitrogen (BUN), serum creatinine and electrolytes, urine volume, changes in liver function, and ascites disappearance in the two groups before and after treatment were compared. Comparison of categorical data between the two groups was made by χ2 test, and comparison of continuous data was made by t test. ResultsPatients in the control group showed no obvious symptom relief, but those in the treatment group had varying degrees of improvement in clinical symptoms. Neither group had significant changes in liver function and serum sodium level after treatment. The treatment group had significantly more patients whose ascites volume had decreased from large to medium than the control group (χ2=5.705, P<0.05). There was a slight but not significant decrease in the levels of BUN and serum creatinine in the control group after treatment with dopamine (all P>0.05), whereas the urine volume showed significant difference after the treatment (t=15.534, P<0.01). The treatment group showed significant differences in the levels of BUN and serum creatinine and urine volume after terlipressin treatment (t=11.535, 9.941, and 19.685, respectively; all P<0.01), and significant differences in those levels were also observed compared with the control group after dopamine treatment (t=7.317, 9.284, and 9.839; all P<0.01). Larger changes in BUN, serum creatinine, andurine volume were observed in the subgroup receiving terlipressin every 8 h than in that receiving terlipressin every 12 h, but the differences were not significant (all P>0.05). Patients treated with terlipressin had mild and tolerable adverse reactions. ConclusionThe domestic terlipressin combined with albumin infusion has good clinical efficacy and mild adverse effects in treating HRS-II. Its clinical application is highly recommended.
【关键字】:肝肾综合征;特利加压素;多巴胺;治疗结果
【Key words】:hepatorenal syndrome ; terlipressin; dopamine; treatment outcome
【引证本文】:

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