前列腺素E1脂微球联合大黄治疗肝肾综合征的疗效观察  

Effect of lipoprostaglandin E1 combined with Chinese rhubarb in treating hepatorenal syndrome

作　　者：唐荣国[1] 孙皆齐[1] 

机构地区：[1]无锡市传染病医院传染科,214000

出　　处：《国际流行病学传染病学杂志》2011年第5期303-305,共3页International Journal of Epidemiology and Infectious Disease

摘　　要：目的观察前列腺素E1脂微球联合大黄治疗肝硬化失代偿期肝肾综合征的疗效。方法26例肝肾综合征患者随机分为2组，在综合治疗的基础上，对照组22例患者给予多巴胺联合大剂量呋塞米，治疗组24例使用前列腺素E1脂微球联合大黄。观察两组疗效、尿量、尿素氮、肌酐、肝功能、血氨及治疗后转归情况。结果治疗组总有效率为85．71％，显著优于对照组的41．67％（70=0．02，P〈0．01）。与治疗前比较，疗程结束时治疗组尿量显著增加（t=8．98，P〈0．01），尿素氮j血肌酐明显降低（t=8．53、17．22，P〈0．01），ALT和TBil有不同程度的改善、血氨下降（t=15．99、4．56、9．22，P〈0．01）；而对照组上述指标均无明显改善。治疗后两组肌酐、尿素氮、ALT、TBi1及血氨比较差异均有统计学意义（t=10．72、8．96、5．86、2．35、9．01，P〈O．05）。结论前列腺素E1脂微球可改善血流动力学变化，增加尿量，而中药大黄可减少肠道毒素吸收，减轻肝肾损害，两者联用有助于肝肾功能的恢复。Objective To observe the effect of lipoprostaglandin E1 （ lipo-PegEl ） with Chinese rhubarb in treatment of patients with hepatorenal syndrome. Methods 26 hepatorenal syndrome patients were divided into two groups randomly. Based on the comprehensive treatment, treatment group（24 cases）were given lipo-PegE1 with Chinese rhubarb, while control group（22 cases）were givendopamine and large-dose of furosemide. The clinical effect, total urine output, BUN, creatinine, liver function, blood ammonia and prognosis were observed. Results The total effective rate was 85.71% in treatment group, and were significantly better than the rate（ 41.67 % ） in control group（ X^2 = 0.02, P 〈 0.01）. In treatment group, urine output were significantly increased after the treatment （ t = 8.98, P 〈 0.01）. BUN and serum creatinine were significandy lower（ t = 8.53, 17.22, P 〈 0.01）, ALT and TBil improved in different degree and blood ammonia decreased （t= 15.99, 4.56, 9.22, P 〈 0.01）; while in control group, these parameters had no significant improvement. After treatment, there were significant differences in creatinine, BUN, ALT, TBil and ammonia between the two groups（ t = 10.72, 8.96, 5.86, 2.35, 9.01, P 〈 0.05）. Conclusions Lipo-PegE1 can change hemodynamics and increase the urine output, while Chinese rhubarb can reduce endotoxin in patients with hepatorenal syndrome, so lipo-Peg, E1 combine with Chinese rhubarb can get enhanced results in the treatment of hepatorenal syndrome.

关 键 词：肝肾综合征 肝硬化 前列腺素E1脂微球 大黄 

分 类 号：R575.2[医药卫生—消化系统] R692[医药卫生—内科学]