摘要
目的观察特利加压素联合人血白蛋白治疗失代偿期乙型肝炎肝硬化并发肝肾综合征的临床效果。方法71例失代偿期乙型肝炎肝硬化并发肝肾综合征患者,随机分为对照组(35例)及观察组(36例)。对照组采用人血白蛋白治疗,观察组采用人血白蛋白联合特利加压素治疗。对比两组相关指标(体质量、24 h尿量、腹围)、肾功能[血肌酐(Scr)、尿素氮(BUN)、Na^(+)]及肌酐清除率、血清胱抑素C、血清β_(2)微球蛋白,并观察观察组不良反应发生情况。结果治疗后14 d,观察组体质量(53.27±7.26)kg低于对照组的(59.03±6.71)kg、24 h尿量(1545±503)ml多于对照组的(820±321)ml,腹围(86.10±8.70)cm小于对照组的(94.20±8.10)cm,差异有统计学意义(P<0.05)。治疗后3、7、14 d,观察组Scr、BUN低于对照组,Na^(+)高于对照组,差异有统计学意义(P<0.05)。治疗后14 d,观察组肌酐清除率(63.88±16.21)ml/min高于对照组的(51.13±15.87)ml/min,血清胱抑素C(0.91±0.27)mg/L、血清β_(2)微球蛋白(1.83±0.89)mg/L低于对照组的(1.42±0.25)、(3.08±1.05)mg/L,差异有统计学意义(P<0.05)。观察组中有11例患者出现大便次数增多,6例患者出现痉挛性腹痛,4例胃肠道反应,4例血压升高,经对症处理及减慢静脉泵入速度后可逐渐缓解,未影响治疗。结论给予失代偿期乙型肝炎肝硬化并发肝肾综合征患者特利加压素联合人血白蛋白治疗,能增加尿量,消退腹水,促进肾功能改善,且有利于肌酐清除率、血清胱抑素C、血清β_(2)微球蛋白的改善,值得借鉴。
Objective To observe the clinical effect of terlipressin combined with human serum albumin in the treatment of decompensated hepatitis B cirrhosis complicated with hepatorenal syndrome.Methods 71 patients with decompensated hepatitis B cirrhosis complicated with hepatorenal syndrome were randomly divided into control group(35 cases)and observation group(36 cases).Patients in the control group were treated with human serum albumin,and patients in the observation group were treated with human serum albumin combined with terlipressin.The relevant indicators(body mass,24-h urine volume,abdominal circumference),renal function[serum creatinine(Scr),urea nitrogen(BUN),Na+]and creatinine clearance,serum cystatin C and serumβ2 microglobulin were compared between the two groups,and the incidence of adverse reactions in the observation group was observed.Results 14 d after the treatment,the body mass of the observation group was(53.27±7.26)kg,which was lower than(59.03±6.71)kg of the control group;the 24-h urine volume of the observation group was(1545±503)ml,which was more than(820±321)ml of the control group;and the abdominal circumference of the observation group was(86.10±8.70)cm,which was less than(94.20±8.10)cm of the control group;and the differences were statistically significant(P<0.05).On 3,7 and 14 d after treatment,Scr and BUN of the observation group were lower than those of the control group,and Na+of the observation group was higher than that of the control group,and the differences were statistically significant(P<0.05).After 14 d of treatment,the creatinine clearance rate of the observation group was(63.88±16.21)ml/min,which was higher than(51.13±15.87)ml/min of the control group;while serum cystatin C of the observation group was(0.91±0.27)mg/L,serumβ2 microglobulin of the observation group was(1.83±0.89)mg/L,which were lower than(1.42±0.25),(3.08±1.05)mg/L of the control group,respectively;and the differences were statistically significant(P<0.05).In the observation group,11 patients had increased stool times,6 patients had spastic abdominal pain,4 patients had gastrointestinal reactions,and 4 patients had elevated blood pressure.After symptomatic treatment and decreasing the speed of intravenous pumping,the adverse reactions could be gradually relieved without affecting the treatment.Conclusion Administration of trelipressin combined with human serum albumin to patients with decompensated hepatitis B cirrhosis and hepatorenal syndrome can increase urine volume,clear ascites,improve renal function,and benefit creatinine clearance and improve serum cystatin C and serumβ2 microglobulin.Thus,it is worthy of considering.
作者
陈小琴
林志刚
陈彬
CHEN Xiao-qin;LIN Zhi-gang;CHEN Bin(Sanming Second Hospital(Fujian Yongan General Hospital),Sanming 366000,China)
出处
《中国现代药物应用》
2021年第24期7-10,共4页
Chinese Journal of Modern Drug Application
关键词
特利加压素
人血白蛋白
失代偿期
乙型肝炎肝硬化
肝肾综合征
效果
Terlipressin
Human serum albumin
Decompensated period
Hepatitis B cirrhosis
Hepatorenal syndrome
Effect
