奥曲肽、特利加压素及两者联合对肝硬化患者肝静脉压力梯度的影响

发布时间：2018-06-19 16:47

本文选题：奥曲肽 + 特利加压素　；参考：《山东大学》2014年硕士论文

【摘要】：目的：奥曲肽和特利加压素是肝硬化患者急性静脉曲张破裂出血(Acute variceal bleeding, AVB)的常用治疗药物。本研究的目的在于分别观察该两种药物及两者联合对肝静脉压力梯度(Hepatic venous pressure gradient, HVPG)的影响。资料与方法：49例肝硬化患者分入A(奥曲肽组)、B(特利加压素组)、C(联合用药组)3组。A(奥曲肽组)给药方式：奥曲肽O.1mg静推(给药时间1min),继以25ug/h泵入,分别测在奥曲肽静脉给药前及给药后1min、5min、10min、15min的WHVP、FHVP和HVPG; B(特利加压素组)给药方式：特利加压素lmg静推(2min内完成),分别测特利加压素静脉给药前及给药后10min、20min、30min的WHVP、FHVP和HVPG值；C(联合用药组)给药及观察方式：首先静脉给予奥曲肽,分别测奥曲肽静脉给药前及给药后1min、5min、10min、15min的WHVP. FHVP和HVPG,再继联合给予特利加压素静推,分别测定联合特利加压素后10min、20min、30min的WHVP、FHVP和HVPG。应用SPSS21.0统计学软件分析奥曲肽和特利加压素两种药物对HVPG的影响作用。结果：A(奥曲肽组),与基础HVPG相比,奥曲肽给药后1min、5min、10min、15min HVPG变化均有统计学意义(P0.05),但5min、10min、15min之间无显著差异(P0.05)。B组(特利加压素组),与基础HVPG相比,特利加压素给药后10min HVPG无显著变化(P0.05),20min、30min HVPG变化则均有统计学意义(P0.05),20min、30min HVPG水平之间亦有显著差异(P0.05)。C组(联合用药组),与奥曲肽给药后15min HVPG相比,加用特利加压素后10min HVPG无显著变化(P0.05),20min、30min HVPG变化均有统计学意义(P0.05),20min、30min HVPG水平之间无显著差异(P0.05)。C组疗效明显大于A、B组(P0.05),A、B组疗效无显著差异(P0.05)。结论：奥曲肽持续给药能很快降低肝硬化门脉高压患者的HVPG,但很快有所回升且趋于稳定。特利加压素单独应用亦能降低HVPG,起效时间比奥曲肽慢。在奥曲肽给药后,加用特利加压素可进一步降低HVPG,故临床中必要时可同时应用两者以加强降门静脉压力的作用。
[Abstract]:Objective: octreotide and telopressin are common drugs for acute variceal hemorrhage in patients with cirrhosis. The purpose of this study was to observe the effects of the two drugs and their combination on the hepatic vein pressure gradient (HVP). Materials and methods Forty-nine patients with liver cirrhosis were divided into two groups: octreotide group (Octreotide group). Group A (Octreotide group 3): octreotide 0.1 mg iv (administration time 1 min), followed by 25ug/h infusion. Before and after intravenous administration of octreotide, the levels of WHVPP-FHVP and HVPGwere measured before and 1 min 5 min and 10 min / 15 min after administration, respectively, and the administration mode of Btril vasopressin group was as follows: lmg was given intravenously within 2 minutes, and the values of lmg and HVPG were measured before intravenous administration and 10 min 20 min after administration respectively. Administration of octreotide by intravenous injection of octreotide and its observation method: the WHVPs of octreotide were measured before intravenous administration and 1 min, 5 min, 10 min and 15 min after administration of octreotide, respectively. FHVP and HVPGwere combined with Trevasopressin to determine the WHVPU FHVP and HVPG at 10 min and 20 min to 30 min after the treatment, respectively. The effects of octreotide and trivasopressin on HVPG were analyzed by SPSS 21.0 software. Results compared with basic HVPG, the changes of HVPG at 1 min, 5 min, 10 min and 15 min after administration of octreotide had statistical significance (P 0.05), but there was no significant difference between group B and group B (Trevasopressin group, compared with basic HVPG), but there was no significant difference between group A (n = 5) and group B (n = 5). There was no significant change in 10min after administration of trivasopressin. There were significant differences in the level of 10min between the two groups (P0.05, P0.05 and 30 min, compared with octreotide, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05 and C, respectively. There was no significant change in 10min after the addition of treponectin for 20 minutes or 30 minutes. There was no significant difference in the level of 10min between the two groups. There was no significant difference between the two groups. The curative effect of group C was significantly higher than that of group A (P 0.05). There was no significant difference (P 0.05) between two groups. Conclusion: continuous administration of octreotide can decrease HVPGs in patients with portal hypertension, but increase rapidly and stabilize. Treponectin alone also decreased HVPGs, and the onset time was slower than octreotide. After the administration of octreotide, the application of trivasopressin can further reduce HVPG.Therefore, both of them can be used simultaneously in clinic to enhance the effect of decreasing portal vein pressure.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R575.2

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