摘要
目的:观察奥曲肽治疗肝硬化门静脉高压食管胃底静脉曲张出血肝静脉压力梯度(HVPG)等的变化,探讨奥曲肽止血机制。方法:采用随机对照的方法,病例分为低剂量奥曲肽治疗组(A组,n=18);高剂量奥曲肽治疗组(B组,n=18)和对照组(C组,n=18)。治疗肝硬化食管胃底静脉曲张出血,在基础治疗(禁食、输液、输血、对症处理)的基础上,全部病例予以奥美拉唑注射液40 mg,每12 h 1次静脉滴注抑酸。治疗组A、B组分别以奥曲肽注射液25、50μg/h的速度微泵静脉维持治疗。观察治疗前后HVPG,门静脉内径,血流速度及呕血、黑便等的改变情况。结果:治疗前与治疗后24、72 h,两治疗组HVPG比较对照组显著降低,有统计学差异(P=0.00,P=0.00)。而治疗组A、B治疗后24 h HVPG有统计学差异(P=0.00),治疗后72 h HVPG无统计学差异(P=0.14)。治疗组比较对照组门静脉内径减小有统计学差异(P<0.05);治疗组A、B与对照组在治疗24、72 h呕血,黑便量相比较明显减少,有统计学差异(P<0.05)。结论:奥曲肽能显著降低HVPG,减少门静脉内径,较高浓度奥曲肽在24 h内疗效更快,奥曲肽联合奥美拉唑比较单独奥美拉唑止血疗效更显著。
AIM： To observe the change of he- patic vein pressure gradient （HVPG） after Octreoti- de treatment of bleeding esophageal varice （BEV）. METHODS： BEV patients were randomly assigned to low dose Octreotide group （ group A, n = 18 ） ; high dose octreotide group （group B, n = 18 ） and control group （n = 18）. The three groups were trea- ted by the same basic method （abrosia, transfusion, blood transfusion and symptomatic treatment）. Pa- tients in group A and B were administered octreotide at a rate of 25 μg/h and 50 μg/h respectively. HVPG and other clinical parameters of patients in all the groups were observed and comparatively ana- lyzed. RESULTS ： The HVPG of patients in group A and B were significantly different before and after 24 h and 72 h post-octreotide treatment compared with that of group C （P = 0.00,P = 0.00）. There was a significant difference between group A and group B after 24 h octreotide treatment also （P = 0.00 ）, but There was no significant difference after 72 h （P = 0.14）. CONCLUSION： Octreotide is effective in the treatment of BEV by reducing HVPG and its effect is significantly different from omeprazole monotherapy.
出处
《中国临床药理学与治疗学》
CAS
CSCD
2015年第4期441-444,共4页
Chinese Journal of Clinical Pharmacology and Therapeutics
