生长抑素联合艾司奥美拉唑钠治疗肝硬化上消化道出血的临床效果

Clinical effect of somatostatin combined with esomeprazole sodium in the treatment of upper gastrointestinal hemorrhage in patients with liver cirrhosis

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摘要目的观察生长抑素联合艾司奥美拉唑钠治疗肝硬化上消化道出血的临床效果。方法选取2020年1月—2024年2月福建省漳州市医院收治的肝硬化上消化道出血患者80例,通过信封法随机分为生长抑素联合组和艾司奥美拉唑钠组,各40例。艾司奥美拉唑钠组给予注射用艾司奥美拉唑钠治疗,生长抑素联合组在艾司奥美拉唑钠组基础上给予注射用生长抑素治疗,治疗3 d后比较2组疗效,治疗前后炎性因子[白介素-6(IL-6)、白介素-8(IL-8)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]、凝血指标[纤维蛋白原(Fib)、凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)]、氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)、胆碱酯酶(CHE)]、血流动力学及不良反应。结果生长抑素联合组总有效率为97.50%,高于艾司奥美拉唑钠组的80.00%(χ^(2)=4.507,P=0.034)。治疗3 d后,2组IL-6、IL-8、CRP、TNF-α、MDA水平及门静脉内径、门静脉血流量、脾静脉内径、脾静脉血流量均降低,Fib、SOD、CHE水平升高,PT、TT、APTT缩短,且生长抑素联合组变化幅度大于艾司奥美拉唑钠组(P<0.01)。生长抑素联合组与艾司奥美拉唑钠组不良反应总发生率比较差异不显著(10.00%vs.7.50%,P=1.000)。结论生长抑素联合艾司奥美拉唑钠治疗肝硬化上消化道出血效果较好,可降低炎性因子水平,改善凝血功能、氧化应激反应、血流动力学,且不良反应少,安全性高。 Objective To observe the clinical effect of somatostatin combined with esomeprazole sodium in the treatment of upper gastrointestinal hemorrhage in patients with liver cirrhosis.Methods A total of 80 patients with upper gastrointestinal hemorrhage due to liver cirrhosis admitted to Zhangzhou Municipal Hospital of Fujian Province from January 2020 to February 2024 were selected and randomly divided into somatostatin combined group and esomeprazole sodium group by envelope method,with 40 cases in each group.The esomeprazole sodium group was treated with esomeprazole sodium for injection,and the somatostatin combined group was treated with somatostatin for injection on the basis of the esomeprazole sodium group.The efficacy after 3 days of treatment,inflammatory factors(IL-6,IL-8,CRP,TNF-α),coagulation indexes(Fib,PT,TT,APTT),oxidative stress indexes(SOD,MDA,CHE),hemodynamics before and after treatment,and adverse reactions were compared between the two groups.Results The total effective rate of the somatostatin combined group was 97.50%,which was higher than 80.00%of the esomeprazole sodium group(χ^(2)=4.507,P=0.034).After 3 days of treatment,the levels of IL-6,IL-8,CRP,TNF-α,MDA,portal vein diameter,portal vein blood flow,splenic vein diameter and splenic vein blood flow were decreased,the levels of Fib,SOD and CHE were increased,PT,TT and APTT were shortened in the two groups.The changes in the somatostatin combined group were greater than those in the esomeprazole sodium group(P<0.01).There was no significant difference in the total incidence of adverse reactions between the somatostatin combined group and the esomeprazole sodium group(10.00%vs.7.50%,P=1.000).Conclusion Somatostatin combined with esomeprazole sodium is effective in the treatment of upper gastrointestinal hemorrhage in patients with liver cirrhosis,which can reduce the level of inflammatory factors,improve coagulation function,oxidative stress response,and hemodynamics,with fewer adverse reactions and high safety.

作者陈琪萍 CHEN Qiping(Department of Gastroenterology,Zhangzhou Municipal Hospital of Fujian Province,Zhangzhou 363000,China)

机构地区福建省漳州市医院消化内科

出处《临床合理用药杂志》 2024年第31期21-25,共5页 Chinese Journal of Clinical Rational Drug Use

基金福建漳州市科技局项目(ZZ2016J07)。

关键词肝硬化上消化道出血生长抑素艾司奥美拉唑钠炎性因子凝血指标氧化应激反应 Liver cirrhosis Upper gastrointestinal hemorrhage Somatostatin Esomeprazole sodium Inflammatory factors Coagulation indicators Oxidative stress response