摘要
目的观察奥曲肽联合普萘洛尔治疗肝硬化上消化道出血患者的效果及对炎性指标水平和门、脾静脉血流的影响。方法选取肝硬化上消化道出血78例,根据治疗方法不同将其分为奥曲肽联合普萘洛尔组(43例)和奥曲肽组(35例)两组。奥曲肽联合普萘洛尔组采用醋酸奥曲肽联合盐酸普萘洛尔治疗,奥曲肽组仅采用醋酸奥曲肽治疗。观察比较两组治疗3 d后临床效果,治疗前及治疗3 d后血清炎性指标水平及门静脉血流量(PVF)、脾静脉血流量(SVF),以及治疗期间不良反应发生情况。结果治疗3 d后,奥曲肽联合普萘洛尔组总有效率高于奥曲肽组,差异有统计学意义(P<0.05)。治疗前,两组血清炎性指标水平及PVF、SVF比较差异均无统计学意义(P>0.05)。治疗3 d后,两组血清C反应蛋白(CRP)、白细胞介素6(IL-6)水平及PVF、SVF均较治疗前降低,血清白细胞介素10(IL-10)水平均较治疗前升高;且奥曲肽联合普萘洛尔组血清CRP、IL-6水平及PVF、SVF低于奥曲肽组,血清IL-10水平高于奥曲肽组,差异有统计学意义(P<0.01)。治疗期间,两组不良反应总发生率比较差异无统计学意义(P>0.05)。结论奥曲肽联合普萘洛尔治疗肝硬化上消化道出血患者可提高临床效果,减轻炎症反应,改善门、脾静脉血流情况,且安全性良好。
Objective To observe the effects of Octreotide combined with Propranolol in the treatment of patients with cirrhosis and upper gastrointestinal hemorrhage and its influence on inflammatory indexes, portal vein blood flow(PVF) and splenic vein blood flow(SVF). Methods Seventy-eight patients with cirrhosis and upper gastrointestinal hemorrhage were selected. According to different treatment regimens, they were divided into Octreotide+Propranolol group(n=43) and Octreotide group(n=35). Octreotide +Propranolol group was treated with Octreotide acetate combined with Propranolol hydrochloride, and Octreotide group was only treated with Octreotide acetate. The clinical effects at 3 d after treatment, levels of serum inflammatory indexes, PVF and SVF before treatment and at 3 d after treatment and occurrence of adverse reactions during treatment were observed and compared between the two groups. Results At 3 d after treatment, the total effective rate in Octreotide+Propranolol group was significantly higher than that in Octreotide group(P<0.05). Before treatment, there were no significant differences in the serum inflammatory indexes levels, PVF and SVF between the two groups(P>0.05). At 3 d after treatment, the levels of serum C-reactive protein(CRP) and interleukin-6(IL-6), PVF and SVF in the two groups were decreased, and the serum IL-10 level was increased compared with those before treatment. The levels of serum CRP and IL-6, PVF and SVF in Octreotide+Propranolol group were significantly lower than those in Octreotide group, and the serum IL-10 level was significantly higher than that in Octreotide group(P<0.01). During treatment, there was no significant difference in the total incidence rate of adverse reactions between the two groups(P>0.05). Conclusion Octreotide combined with Propranolol for patients with cirrhosis and upper gastrointestinal hemorrhage can improve the therapeutic effects, reduce the inflammatory response, and promote PVF and SVF, and it has good safety.
作者
华鹏
崔翔
周荣赛
米俊
HUA Peng;CUI Xiang;ZHOU Rong-sai;MI Jun(Department of Gastroenterology,Ankang Hospital of Traditional Chinese Medicine,Ankang,Shaanxi 725000,China;Department of Emergency,Ankang Hospital of Traditional Chinese Medicine,Ankang,Shaanxi 725000,China)
出处
《临床误诊误治》
2020年第5期44-48,共5页
Clinical Misdiagnosis & Mistherapy
基金
陕西省科技厅项目(2018KJXX-072)
安康市科技局项目(2018AK03-03)。
