特利加压素联合白蛋白治疗Ⅱ型肝肾综合征患者的疗效
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摘要
目的探讨特利加压素联合白蛋白治疗Ⅱ型肝肾综合征患者的临床疗效。方法Ⅱ型肝肾综合征患者88例随机均分为两组。观察组给予特利加压素联合白蛋白治疗,对照组给予白蛋白治疗。治疗2周后,观察两组总有效率、体重、腹围、24-h尿量、肝功能、肾功能和不良反应,并对患者进行随访。结果治疗后,观察组总有效率高于对照组(84.1%vs.63.6%)(P<0.05),两组患者体重、腹围、24-h尿量、ALT、白蛋白、BUN及肌酐较治疗前改善(P<0.05),且观察组改善更为明显(P<0.05)。治疗期间,两组患者均未出现严重不良反应。随访1年,观察组生存率为90.9%,高于对照组的75.0%(P<0.05)。结论特利加压素联合白蛋白治疗Ⅱ型肝肾综合征患者疗效优于单用白蛋白治疗,不良反应少。
Objective To investigate the efficacy of terlipressin combined with albumin in the treatment of patients with typeⅡ hepatorenal syndrome.Methods A total of 88 cases with typeⅡhepatorenal syndrome was equally divided into two groups.Group A was treated with terlipressin combined with albumin and group C was treated with albumin alone.The overall effectiveness rate,weight,abdominal circumference,24-h urine volume,liver and kidney function and adverse responses were observed.One-year survival rate was followed up.Results The overall effectiveness rate was higher in group A than that in group C(84.1% vs.63.6%)(P<0.05).Compare to before,the weight,abdominal circumference,24-h urine volume,ALT,albumin,BUN and creatinine were all improved after treatment,which were better in group A than those in group C(P<0.05).No severe adverse responses during treatment were observed in two groups.The one-year survival rate was higher in group A than that in group C(90.9% vs.75.0%)(P<0.05).Conclusion Compared to albumin treatment alone,terlipressin combined with albumin has better efficacy and less adverse responses in the patients with typeⅡ hepatorenal syndrome.
Objective To investigate the efficacy of terlipressin combined with albumin in the treatment of patients with typeⅡ hepatorenal syndrome.Methods A total of 88 cases with typeⅡhepatorenal syndrome was equally divided into two groups.Group A was treated with terlipressin combined with albumin and group C was treated with albumin alone.The overall effectiveness rate,weight,abdominal circumference,24-h urine volume,liver and kidney function and adverse responses were observed.One-year survival rate was followed up.Results The overall effectiveness rate was higher in group A than that in group C(84.1% vs.63.6%)(P<0.05).Compare to before,the weight,abdominal circumference,24-h urine volume,ALT,albumin,BUN and creatinine were all improved after treatment,which were better in group A than those in group C(P<0.05).No severe adverse responses during treatment were observed in two groups.The one-year survival rate was higher in group A than that in group C(90.9% vs.75.0%)(P<0.05).Conclusion Compared to albumin treatment alone,terlipressin combined with albumin has better efficacy and less adverse responses in the patients with typeⅡ hepatorenal syndrome.
引文
[1]李慧,金哲,吴利娟,等.特利加压素联合白蛋白治疗Ⅰ型肝肾综合征疗效的荟萃分析[J].世界华人消化杂志,2016,24(36):4805-4812.
[2]尹伟,李成忠.特利加压素治疗肝肾综合征的疗效、预后及相关影响因素[J].肝脏,2016,21(2):100-104.
[3]张驰豪,罗蒙.肝肾综合征发病机制的研究进展[J].肝胆胰外科杂志,2016,28(4):343-345.
[4]占国清,李芳,李儒贵,等.特利加压素治疗肝硬化顽固性腹水合并Ⅱ型肝肾综合征的疗效观察[J].临床肝胆病杂志,2015,31(8):1287-1290.
[5]胡爱荣,蒋素文,胡耀仁.肝硬化急性肾损伤及肝肾综合征的诊治路径[J].中华危重病急救医学,2016,28(3):193-199.
[6]宋廷雪,祁兴顺,高帆,等.肝硬化肝肾综合征型急性肾损伤的诊治进展[J].临床肝胆病杂志,2017,33(3):572-576.
[7]Runyon BA,AASLD.Introduction to the revised American Association for the Study of Liver Diseases Practice Guideline management of adult patients with ascites due to cirrhosis2012[J].Hepatology,2013,57(4):1651-1653.
[8]谌琦,李月红.肝肾综合征诊治进展[J].中华老年多器官疾病杂,2017,16(8):633-636.
[9]王文苓,苏晓峰,苏梅,等.肝硬化并发肝肾综合征临床特点及死亡危险因素分析[J].传染病信息,2017,30(2):95-98.
[10]Heemann U,Füeβl HS,Renders L.The hepatorenal syndrome[J].Dtsch Med Wochenschr,2015,140(20):1520-1523.
[11]李伟,安文军.白蛋白联合特利加压素治疗肝肾综合征患者的临床疗效[J].新疆医科大学学报,2017,40(9):1145-1148.
[12]张茜,罗新华.特利加压素联合小剂量白蛋白治疗肝肾综合征的疗效观察[J].贵州医药,2015,39(6):527-528.
[13]Song T,R9ssle M,He F,et al.Transjugular intrahepatic portosystemic shunt for hepatorenal syndrome:a systematic review and meta-analysis[J].Dig Liver Dis,2018,50(4):323-330.
[14]彭阿平,朱萱.肝肾综合征的发病机制及诊治的研究进展[J].世界华人消化杂志,2015,23(9):1440-1446.
[15]Sauerbruch T,Appenrodt B,Schmitz V,et al.The conservative and interventional treatment of the complications of liver cirrhosis:part 2of a series on liver cirrhosis[J].Dtsch Arztebl Int,2013,110(8):126-132.
[16]李思阳,田英俊,李德春,等.肝硬化患者失代偿期发生肝肾综合征的危险因素分析[J].中国医师杂志,2016,18(11):1723-1725.
[17]Srivastava S,Shalimar,Vishnubhatla S,et al.Randomized controlled trial comparing the efficacy of terlipressin and albumin with a combination of concurrent dopamine,furosemide,and albumin in hepatorenal syndrome[J].J Clin Exp Hepatol,2015,5(4):276-285.
[18]程计林,陈丽萍,吴云林.特利加压素治疗门静脉高压症相关并发症的研究进展[J].内科理论与实践,2015,10(4):246-250.
[19]崔瑞冰,阎明.肝肾综合征的病理生理学及诊疗进展[J].中华肝脏病杂志,2017,25(4):246-248.
[20]吴军.特利加压素与托拉塞米治疗失代偿期肝硬化并发肝肾综合征患者疗效比较[J].实用肝脏病杂志,2015,18(1):78-79.
[21]陈丽,梅永,杨亦彬,等.肾脏替代疗法治疗肝肾综合征的研究进展[J].临床肝胆病杂志,2016,32(3):605-608.
[22]陈振娟,吴安城,李金金,等.特利加压素治疗肝肾综合征患者临床有效性及安全性的Meta分析[J].中国肝脏病杂志(电子版),2016,8(4):22-25.
[23]莫东,谢宁,严柳媚,等.肝硬化肝肾综合征患者肾功能与血氨水平的临床相关性研究[J].胃肠病学和肝病学杂志,2015,24(11):1335-1337.
[24]伍小青.肝肾综合征65例临床分析[J].当代医学,2015,21(7):62-63.
[25]丁晓红,顾建英.特利加压素治疗Ⅱ型肝肾综合征的临床疗效观察[J].临床肝胆病杂志,2015,31(5):745-748.
[26]李耀威,李荣山,米变涛.84例肝肾综合征患者临床特征[J].国际移植与血液净化杂志,2016,14(3):11-17.
[2]尹伟,李成忠.特利加压素治疗肝肾综合征的疗效、预后及相关影响因素[J].肝脏,2016,21(2):100-104.
[3]张驰豪,罗蒙.肝肾综合征发病机制的研究进展[J].肝胆胰外科杂志,2016,28(4):343-345.
[4]占国清,李芳,李儒贵,等.特利加压素治疗肝硬化顽固性腹水合并Ⅱ型肝肾综合征的疗效观察[J].临床肝胆病杂志,2015,31(8):1287-1290.
[5]胡爱荣,蒋素文,胡耀仁.肝硬化急性肾损伤及肝肾综合征的诊治路径[J].中华危重病急救医学,2016,28(3):193-199.
[6]宋廷雪,祁兴顺,高帆,等.肝硬化肝肾综合征型急性肾损伤的诊治进展[J].临床肝胆病杂志,2017,33(3):572-576.
[7]Runyon BA,AASLD.Introduction to the revised American Association for the Study of Liver Diseases Practice Guideline management of adult patients with ascites due to cirrhosis2012[J].Hepatology,2013,57(4):1651-1653.
[8]谌琦,李月红.肝肾综合征诊治进展[J].中华老年多器官疾病杂,2017,16(8):633-636.
[9]王文苓,苏晓峰,苏梅,等.肝硬化并发肝肾综合征临床特点及死亡危险因素分析[J].传染病信息,2017,30(2):95-98.
[10]Heemann U,Füeβl HS,Renders L.The hepatorenal syndrome[J].Dtsch Med Wochenschr,2015,140(20):1520-1523.
[11]李伟,安文军.白蛋白联合特利加压素治疗肝肾综合征患者的临床疗效[J].新疆医科大学学报,2017,40(9):1145-1148.
[12]张茜,罗新华.特利加压素联合小剂量白蛋白治疗肝肾综合征的疗效观察[J].贵州医药,2015,39(6):527-528.
[13]Song T,R9ssle M,He F,et al.Transjugular intrahepatic portosystemic shunt for hepatorenal syndrome:a systematic review and meta-analysis[J].Dig Liver Dis,2018,50(4):323-330.
[14]彭阿平,朱萱.肝肾综合征的发病机制及诊治的研究进展[J].世界华人消化杂志,2015,23(9):1440-1446.
[15]Sauerbruch T,Appenrodt B,Schmitz V,et al.The conservative and interventional treatment of the complications of liver cirrhosis:part 2of a series on liver cirrhosis[J].Dtsch Arztebl Int,2013,110(8):126-132.
[16]李思阳,田英俊,李德春,等.肝硬化患者失代偿期发生肝肾综合征的危险因素分析[J].中国医师杂志,2016,18(11):1723-1725.
[17]Srivastava S,Shalimar,Vishnubhatla S,et al.Randomized controlled trial comparing the efficacy of terlipressin and albumin with a combination of concurrent dopamine,furosemide,and albumin in hepatorenal syndrome[J].J Clin Exp Hepatol,2015,5(4):276-285.
[18]程计林,陈丽萍,吴云林.特利加压素治疗门静脉高压症相关并发症的研究进展[J].内科理论与实践,2015,10(4):246-250.
[19]崔瑞冰,阎明.肝肾综合征的病理生理学及诊疗进展[J].中华肝脏病杂志,2017,25(4):246-248.
[20]吴军.特利加压素与托拉塞米治疗失代偿期肝硬化并发肝肾综合征患者疗效比较[J].实用肝脏病杂志,2015,18(1):78-79.
[21]陈丽,梅永,杨亦彬,等.肾脏替代疗法治疗肝肾综合征的研究进展[J].临床肝胆病杂志,2016,32(3):605-608.
[22]陈振娟,吴安城,李金金,等.特利加压素治疗肝肾综合征患者临床有效性及安全性的Meta分析[J].中国肝脏病杂志(电子版),2016,8(4):22-25.
[23]莫东,谢宁,严柳媚,等.肝硬化肝肾综合征患者肾功能与血氨水平的临床相关性研究[J].胃肠病学和肝病学杂志,2015,24(11):1335-1337.
[24]伍小青.肝肾综合征65例临床分析[J].当代医学,2015,21(7):62-63.
[25]丁晓红,顾建英.特利加压素治疗Ⅱ型肝肾综合征的临床疗效观察[J].临床肝胆病杂志,2015,31(5):745-748.
[26]李耀威,李荣山,米变涛.84例肝肾综合征患者临床特征[J].国际移植与血液净化杂志,2016,14(3):11-17.