特利加压素与加倍剂量奥曲肽对肝硬化患者肝静脉压力梯度影响的比较

冯庆玲; 冯泽民; 张春清; 王广川; 冯华

doi:10.3969/j.issn.1001-5256.2016.04.022

特利加压素与加倍剂量奥曲肽对肝硬化患者肝静脉压力梯度影响的比较

DOI: 10.3969/j.issn.1001-5256.2016.04.022

山东大学附属省立医院东院消化科

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中图分类号: R575.2
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出版历程
- 出版日期: 2016-04-20

Effects of terlipressin and double- dose octreotide on hepatic venous pressure gradient in patients with liver cirrhosis:a comparative study

Department of Gastroenterology, East Branch of Shandong Provincial Hospital Affiliated to Shandong University

摘要

摘要:
目的比较特利加压素与加倍剂量奥曲肽降低肝硬化患者肝静脉压力梯度（HVPG）的疗效。方法选取2014年6月-2015年3月于山东大学附属省立医院确诊为肝硬化合并食管胃底静脉曲张的患者41例,随机分为特利加压素组（A组,n=22）和奥曲肽组（B组,n=19）。A组静脉推注特利加压素2 mg;B组静脉推注奥曲肽100μg,后以50μg/h维持静脉输注。分别于给药前及给药后10、20、30 min测定HVPG,观察2组患者用药前后HVPG降低幅度以及血压、心率变化情况。计量资料2组间比较采用t检验,计数资料2组间比较使用χ2检验或Fisher确切概率法。结果给药前及给药10、20、30 min后,HVPG在A组由（18.86±5.66）mm Hg降至（16.75±5.54）、（16.14±5.43）、（15.25±5.93）mm Hg;B组由（19.91±6.68）mm Hg降至（16.58±5.86）、（17.03±6.14）、（17.66±6.09）mm Hg;每组给药后各时间点与治疗前比较差异均有统计学意义（t值分别为4.010、6.413、5...
- 肝硬化 /
- 肝静脉 /
- 静脉压 /
- 特利加压素 /
- 奥曲肽 /
- 对比研究
Abstract:
Objective To investigate the efficacy of terlipressin and double- dose octreotide in reducing hepatic venous pressure gradient( HVPG) in patients with liver cirrhosis. Methods A total of 41 patients who were diagnosed with liver cirrhosis and esophageal and gastric varices in our hospital from June 2014 to March 2015 were randomly divided into terlipressin group( group A,22 patients) and octreotide group( group B,19 patients). The patients in group A were given intravenous injection of terlipressin 2 mg,and those in group B were given intravenous injection of octreotide 100 μg followed by intravenous infusion of the same drug at 50 μg / h. HVPG was measured before administration and at 10,20,and 30 min after administration,and the reduction in HVPG and changes in blood pressure and heart rate after administration were observed. The t- test was applied for comparison of continuous data between groups,and the chi- square test or Fisher's exact test was applied for comparison of categorical data between groups. Results In group A,HVPG before administration and at 10,20,and 30 min after administration was 18. 86 ± 5. 66,16. 75 ± 5. 54,16. 14 ± 5. 43,and 15. 25 ± 5. 93 mm Hg,respectively,while in group B,HVPG at the above time points was 19. 91 ± 6. 68,16. 58 ± 5. 86,17. 03 ± 6. 14,and 17. 66 ± 6. 09 mm Hg,respectively; each group showed a significant change in HPVG at each time point after administration compared with that before administration( t = 4. 010,6. 413,5. 134,5. 533,5. 741,and 4. 017,all P < 0. 05),while the reduction in HVPG after administration showed no significant differences across the two groups. The patients in both groups experienced varying degrees of reduction in heart rate and increase in blood pressure.Group A had a significantly larger reduction in heart rate compared with group B( 16. 13% ± 9. 28% vs 3. 35% ± 6. 34%; t =- 5. 062,P < 0. 001); group A had a significantly larger increase in blood pressure compared with group B( 17. 06 ± 8. 11% vs 11. 70 ± 7. 76%; t =2. 178,P = 0. 037). Conclusion Terlipressin and double- dose octreotide can effectively reduce HVPG in patients with liver cirrhosis and esophageal and gastric varices. Terlipressin can reduce HVPG more obviously over time,but terlipressin has a greater influence on heart rate and blood pressure.
- liver cirrhosis /
- hepatic veins /
- venous pressure /
- terlipressin /
- octreotide /
- comp study

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参考文献(12)

[1]ABRALDES JG,SARLIEVE P,TANDON P,et al.Measurement of portal pressure[J].Clin Liver Dis,2014,18(4):779-792.

[2]LA MURA V,ABRALDES JG,RAFFA S,et al.Prognostic value of acute hemodynamic response to i.v.propranolol in patients with cirrhosis and portal hypertension[J].J Hepatol,2009,51(2):279-287.

[3]SHAH HA,AZAM Z,RAUF J,et al.Carvedilol vs.esophageal variceal band ligation in the primary prophylaxis of variceal hemorrhage:a multicentre randomized controlled trial[J].J Hepatol,2014,60(4):757-764.

[4]XIA YL,ZHANG CQ,WANG GC,et al.Individual and combined effects of octreotide and terlipressin on hepatic venous pressure gradient in cirrhotic patients[J].J Clin Hepatol,2015,31(2):214-218.(in Chinese)夏玉莲,张春清,王广川,等.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[J].临床肝胆病杂志,2015,31(2):214-218.

[5]de FRANCHIS R,BAVENO VI FACULTY.Expanding consensus in portal hypertension:report of the BavenoⅥConsensus Workshop:stratifying risk and individualizing care for portal hypertension[J].J Hepatol,2015,63(3):743-752.

[6]GARCIA-PAGAN JC.Hepatic venous pressure gradient and prognosis in patients with acute variceal bleeding treated with pharmacologic and endoscopic therapy[J].Semin Liver Dis,2008,48(2):229-236.

[7]VILLANUEVA C,PIQUERAS M,ARACIL C,et al.A randomized controlled trial comparing ligation and sclerotherapy as emergency endoscopic treatment added to somatostatin in acute variceal bleeding[J].JHepatol,2006,45(4):560-567.

[8]GARCIA-TSAO G.Effectiveness of combined pharmacologic and ligation therapy in high-risk patients with acute esophageal variceal bleeding[J].AM J Gastroenterol,2011,106(10):1787-1795.

[9]TAKASHIMIZU S,KOJIMA S,NISHIZAKI Y,et al.Effect of endothelin A receptor antagonist on hepatic hemodynamics in cirrhotic rats.Implications for endothelin-1 in portal hypertension[J].Tokal J Exp Clin Med,2011,36(2):37-43.

[10]Cooperative Study Group of Octreotide in China.Efficacy of octreotide in the treatment of acute variceal bleeding in cirrhotic patients:a prospective,multicentric and randomized clinical trial[J].Chin J Dig,2005,25(1):37-40.(in Chinese)奥曲肽全国协作组.两种剂量奥曲肽治疗食管、胃静脉曲张大出血多中心随机对照临床疗效观察[J].中华消化杂志,2005,25(1):37-40.

[11]ESCORSELL A,BANDI JC,ANDREU V,et al.Desensitization to the effects of intravenous octreotide in cirrhotic patients with portal hypertension[J].Gastroenterology,2001,120(1):161-169.

[12]WU Y,CHENG CS.Comparision the effect and safety of terlipressin vs octreotide on treatment of upper gastrointestinal hemorrhage in liver cirrhosis[J].Chin J Clin Gastroenterol,2015,27(1):23-26.(in Chinese)吴燕,程昌盛.特利加压素与奥曲肽治疗肝硬化上消化道出血的效果与安全性比较[J].临床消化病杂志,2015,27(1):23-26.

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