首 页   本刊简介  编委会  审稿专家  在线期刊  写作规范  广告合作  联系我们
您现在的位置:首页 => 在线期刊 => 2020年 6期“非酒精性脂肪性肝病与多代谢紊乱的基础与临床” => 肝纤维化及肝硬化 =>特利加压素联合生长抑..
特利加压素联合生长抑素治疗肝硬化食管胃静脉曲张出血的效果分析
Clinical effect of terlipressin combined with somatostatin in treatment of esophagogastric variceal bleeding with liver cirrhosis
文章发布日期:2020年06月01日  来源:  作者:李晓路,丁惠国,曾阿娟,等  点击次数:187次  下载次数:50次

调整字体大小:

(此处下载失败可以在在线预览处保存副本或者右键另存为)

【摘要】:目的 探析特利加压素联合生长抑素治疗肝硬化食管胃静脉曲张出血(EVB)患者的效果。方法 回顾性分析2017年9月-2019年2月在首都医科大学附属北京佑安医院肝病消化中心住院治疗的73例肝硬化EVB患者的临床资料。在抑酸对症治疗的基础上,加用生长抑素治疗的患者43例,加用特利加压素治疗的8例,加用特利加压素联合生长抑素治疗的22例。比较3组患者24 h止血成功率、止血时间、早期再出血率、迟发性再出血率、并发急性肾损伤(AKI)治疗改善率及半年累积生存率情况。符合正态分布的计量资料3组间比较采用单因素方差分析;非正态分布的计量资料3组间比较采用Kruskal-Wallis H秩和检验。计数资料3组间比较采用χ2检验。采用累积风险函数(CIF)描述病死率,采用竞争风险模型(Gray’s Test)检验3组生存率的差异。结果 联合治疗组、生长抑素组、特利加压素组24 h内止血成功率分别为54.5%、41.9%、37.5%,止血时间分别为1.00(1.00~3.00)d、2.00(1.00~3.00)d、2.00(1.00~3.00)d,早期再出血率分别为25%、27.5%、16.7%, 迟发性再出血率分别为16.7%,27.3%、40%,以上指标3组间差异均无统计学意义(P值均>0.05);联合治疗组与生长抑素组并发AKI患者的治疗改善率分别为100%、50%,差异无统计学意义(P=0.429);3组患者的半年累积生存率差异无统计学意义(部分分布风险比=1.40, 95%CI: 0.60~3.27,P=0.436)。结论 特利加压素联合生长抑素与单用生长抑素、单用特利加压素均可有效控制肝硬化EVB,3种治疗方案治疗效果无明显差异;与单用生长抑素相比,联合应用特利加压素对改善AKI方面具有潜在优势。
【Abstract】:Objective To investigate the clinical effect of terlipressin combined with somatostatin in the treatment of esophagogastric variceal bleeding (EVB) in patients with liver cirrhosis. Methods A retrospective analysis was performed for the clinical data of 73 patients with liver cirrhosis and EVB who were treated in Department of Gastronenterology and Hepatology, Beijing YouAn Hospital, Capital Medical University, from September 2017 to February 2019. In addition to anti-acid therapy, 43 patients were treated with somatostatin, 8 patients were treated with terlipressin, and 22 patients were treated with terlipressin combined with somatostatin. The three groups were compared in terms of 24-hour success rate of hemostasis, hemostatic time, early rebleeding rate, delayed rebleeding rate, improvement rate of acute kidney injury (AKI), and half-year cumulative survival rate. A one-way analysis of variance was used for comparison of normally distributed continuous data between the three groups, and the Kruskal-Wallis H rank sum test was used for comparison of non-normally distributed continuous data between the three groups; the chi-square test was used for comparison of categorical data between groups. The cumulative incidence function was used to describe mortality rate, and a competing risk model (Gray’s Test) was used for comparison of survival rates between the three groups. Results There were no significant differences between the combination group, the somatostatin group, and the terlipressin group in 24-hour success rate of hemostasis (54.5%, 41.9%, and 37.5%, respectively), hemostatic time [1.00 (1.00-3.00) d, 2.00 (1.00-3.00) d, and 2.00 (1.00-3.00) d, respectively], early rebleeding rate (25%, 27.5%, and 16.7%, respectively), and delayed rebleeding rate (16.7%, 27.3%, and 40%, respectively) (all P>0.05). There was no significant difference in the improvement rate of AKI patients after treatment between the combination group and the somatostatin group (100% vs 50%, P=0.429). There was no significant difference in the half-year cumulative survival rate between the three groups (SHR=1.40, 95% confidence interval: 0.60-3.27, P=0.436). Conclusion Terlipressin combined with somatostatin, somatostatin alone, and terlipressin alone can effectively control EVB in liver cirrhosis and have similar clinical effects. Compared with somatostatin alone, somatostatin combined with terlipressin has a potential advantage in improving AKI.
【关键字】:肝硬化; 高血压,门静脉; 食管和胃静脉曲张; 特利加压素; 生长抑素
【Key words】:liver cirrhosis; hypertension,portal; esophageal and gastricvarices; terlipressin; somatostatin
【引证本文】:LI XL, DING HG, ZENG AJ, et al. Clinical effect of terlipressin combined with somatostatin in treatment of esophagogastric variceal bleeding with liver cirrhosis[J]. J Clin Hepatol, 2020, 36(6): 1273-1277. (in Chinese)
李晓路, 丁惠国, 曾阿娟, 等. 利加压素联合生长抑素治疗肝硬化食管胃静脉曲张出血的效果分析[J]. 临床肝胆病杂志, 2020, 36(6): 1273-1277.

地址:长春市东民主大街519号《临床肝胆病杂志》编辑部 邮编:130061 电话:0431-88782542/3542
临床肝胆病杂志 版权所有 Copyright © 2009 - 2013 Lcgdbzz.org. All Rights Reserv 吉ICP备10000617号

吉公网安备 22010402000041号