摘要
目的观察多巴胺联合特利加压素治疗Ⅰ型肝肾综合征的临床疗效。方法采用回顾性研究根据入院时间将63例Ⅰ型肝肾综合征患者根据肝硬化Child-pugh评分随机分为三组,三组患者在年龄、性别及临床症状、体征及肝肾损害方面均有可比性,三组患者治疗前血肌酐(Cr)、尿素氮(BUN)、Na+比较差异无统计学意义。其中多巴胺治疗组21例(Ⅰ组),多巴胺联合特利加压素治疗组21例(Ⅱ组),常规治疗对照组21例(Ⅲ组)。比较三组治疗前后临床治愈好转率,并观察Cr、BUN、Na+、K+定量检测指标的变化。结果治疗后Ⅰ组总有效率为33.3%(7/21),Ⅱ组总有效率为71.4%(15/21),Ⅲ组总有效率为28.6%(6/21)。Ⅰ组与Ⅲ组比较差异无统计学意义(χ2=0.14,P>0.05);Ⅱ组疗效优于Ⅰ组(χ2=8.00,P<0.05)与Ⅲ组(χ2=9.56,P<0.05),差异有统计学意义;Ⅱ组治疗结束后肾功能明显好转,电解质紊乱纠正,检测Cr、BUN、Na+与Ⅲ组比较差异有统计学意义(t1=2.45,t2=3.56,t3=2.67,P<0.05)。结论多巴胺联合特利加压素治疗Ⅰ型肝肾综合征有较好疗效。
Objective To observe the clinical efficacy of dopamine combined with terlipressin for the treatment of type I hepatorenal syndrome. Methods According to child-pugh scores, 63 patients with hepatorenal syndrome type I were randomly divided into three groups, There was no significant difference between the three groups in age, sex and clinical symptoms and liver and kidney damnification （P 〉 0. 05 ）, Cr, BUN, Na^＋ of three groups before treatment showed no significant difference （P 〉 0. 05）. 21 patients were treated with dopaminergic （group I ）, 21 patients were treated with dopamine combined with terhpressin （ group II ）, other 21 patients were treated with conventional therapeuic schedule （ group II1 ）. Clinical cure rates and amelioration rates of three groups were compared, and the changes of Cr, BUN, Na ＋ , K~ before and after treatement were observed. Results The total effective rates of three groups were was 33.3% （7/21）, 71.4% （ 15/21 ） and 28.6% （6/21）. There was no significant difference between Group I and Group HI （P 〉 0. 05） ; the effective rate of group H was significantly higher than group I （X^2 = 8.00, P 〈 0.05 ） and group m （X^2 = 9. 56, P 〈 0. 05 ） ; the renal function of patients in group H improved significantly after treatment and electrolyte imbalances were corrected, the differences of Cr, BUN, Na^＋ between group Ⅱ and Ⅲ were statistically significant（t =2. 45, P〈0. 05; t =3.56, P〈0. 05; t =2. 67, P 〈 0.05 ）. Conclusions The curative effect of Dopamine combined with terlipressin for type I hepatorenal syndrome is very notable.
出处
《中华消化病与影像杂志（电子版）》
2013年第3期4-7,共4页
Chinese Journal of Digestion and Medical Imageology(Electronic Edition)
