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目的:评价不同剂量特利加压素对肝硬化伴Ⅰ型肝肾综合征患者肾功能衰竭的临床疗效。方法:选取2012年4月—2014年12月间肝病科救治的肝硬化伴Ⅰ型肝肾综合征患者48例作为研究对象,根据特利加压素的用量不同将其分为高剂量组(24例)和低剂量组(24例);高剂量组患者均给予静脉推注特利加压素2 mg/6 h治疗,而低剂量组患者则给予静脉推注特利加压素2 mg/12 h治疗;比较两组患者治疗前和治疗后第7天和第14天24 h尿量、血清尿素氮、肌酐和Na+浓度和总有效率与转归情况。结果:高剂量组患者24 h尿量明显高于低剂量组(P<0.05);两组患者治疗前与治疗7~14 d后血清Na+浓度经组间比较其差异无统计学意义(P>0.05);但高剂量组患者治疗后的总有效率明显高于低剂量组(P<0.05)。结论:采用不同剂量特利加压素治疗肝硬化伴Ⅰ型肝肾综合征患者,治疗第7天的疗效较为明显,但治疗第14天高、低剂量的疗效无差异。
Objective: To evaluate the clinical effects of different doses of terlipressin on renal failure in cirrhotic patients with type Ⅰ hepatorenal syndrome. Methods: Forty-eight patients with liver cirrhosis and type Ⅰ hepatorenal syndrome who were treated by Department of Hepatology between April 2012 and December 2014 were selected as the study subjects. According to the different doses of terlipressin, they were divided into high dose group ( 24 patients) and low-dose group (24 patients). Patients in high-dose group were treated with intravenous infusion of terlipressin 2 mg / 6 h, while those in low-dose group were given intravenous infusion of terlipressin 2 mg / 12 h treatment. The 24 h urinary output, serum urea nitrogen, creatinine and Na + concentration, total effective rate and outcome were compared between the two groups before treatment and on the 7th and 14th day after treatment. Results: The urine output of 24 h in high dose group was significantly higher than that of low dose group (P <0.05). There was no significant difference in serum Na + concentration between before treatment and after 7 ~ 14 d of treatment (P> 0.05). However, the total effective rate of high-dose group was significantly higher than that of low-dose group (P <0.05). Conclusion: The effect of different doses of terlipressin on cirrhosis patients with type Ⅰ hepatorenal syndrome is obvious on the 7th day, but there is no difference between the high and low dose on the 14th day.