Objective The administration of octreotide,as well as terlipressin,is a routine treatment for acute variceal bleeding in cirrhotic patients. This study aimed to evaluate the effects of octreotide,terlipressin,and their combination on hepatic venous pressure gradient( HVPG) in cirrhotic patients. Methods The study enrolled 49 cirrhotic patients with varicose veins who were hospitalized at the Department of Gastroenterology,Shandong Provincial Hospital Affiliated to Shandong University during January 2011 to April 2014. The patients were divided into three groups: group A( octreotide alone),group B( terlipressin alone),and group C( the combination). Group A: Octreotide was administered via intravenous injection of 1. 0 mg within 1 min followed by intravenous pumping at 25 μg / h,and HVPG was measured before drug administration and at 1,5,10,and 15 min after the start of octreotide injection. Group B: Terlipressin was administered by intravenous injection of 1 mg within 2 min,and HVPG was measured before drug administration and at 10,20,and 30 min after the start of terlipressin injection. Group C: First,octreotide was administered and HVPG was measured as performed for group A; then,terlipressin was given and HVPG was measured as performed for group B. Data were statistically analyzed using the t test,analysis of variance,and chi- square test. Results In group A,HVPG was significantly decreased at different time points after octreotide injection( t = 13. 173,P < 0. 001; t = 5. 364,P < 0. 001; t = 3. 894,P = 0. 001; t = 4. 160,P < 0. 001),but no significant differences were found between 5,10,and 15 min( all P > 0. 05). In group B,HVPG was significantly decreased at 20 min after terlipressin injection( t = 4. 062,P = 0. 002),with significant difference between 20 and 30 min( t = 4. 022,P = 0. 002). In group C,HVPG was further decreased at 20 min after terlipressin injection( t = 4. 926,P < 0. 001),with no significant difference between 20 and 30 min( t = 1. 733,P = 0. 101). A better effect was achieved in group C than in groups A and B( F = 10. 423,P < 0. 05). Conclusion Continuous octreotide injection rapidly reduces HVPG in cirrhotic patients with portal hypertension,but HVPG gradually increases to a stable level in a short period. Terlipressin injection also reduces HVPG but works more slowly than octreotide. Terlipressin injection after octreotide further reduces HVPG,indicating a better combined effect of the drugs than individual ones.
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