去甲肾上腺素联合白蛋白治疗肝肾综合征临床疗效观察  

The Study on Noradrenalin Combined with Albumin in the Treatment of Hepatorenal Syndrome

作　　者：唐文[1] 蒋明德[1] 徐辉[1] 秦建平[1] 沈才飞[1] 

机构地区：[1]成都军区总医院消化内科,四川省成都市610083

出　　处：《医学理论与实践》2012年第2期131-133,共3页The Journal of Medical Theory and Practice

摘　　要：目的:观察去甲肾上腺素联合白蛋白治疗HRS患者的疗效。方法:回顾性分析我院2008年1月-2010年12月153例HRS住院患者临床资料(其中,Ⅰ型36例,Ⅱ型117例),分为对照组和去甲肾上腺素联合白蛋白治疗组(治疗组),分析HRS患者的基础疾病,总胆红素、肌酐、MELD评分、尿量变化以及住院病死率等。结果:Ⅰ型HRS患者治疗组治疗后除总胆红素外,肌酐、MELD评分以及尿量与对照组治疗后相应指标比较差异均有统计学意义(P<0.05);治疗组治疗前、后比较,肌酐及MELD评分降低、尿量增加差异均有统计学意义(P<0.05)。Ⅱ型HRS患者治疗组治疗后总胆红素、肌酐、MELD评分和尿量与对照组治疗后各指标比较差异均有统计学意义(P<0.05);治疗组治疗前、后各指标比较,总胆红素、肌酐及MELD评分降低,尿量增加,差异均有统计学意义(P<0.05)。Ⅰ型HRS患者治疗组与对照组病住院死率(40.0%VS 81.3%)比较差异有统计学意义(χ2=6.223,P<0.05);Ⅱ型HRS患者治疗组与对照组住院病死率(18.2%VS 47.1%)比较差异有统计学意义(χ2=11.262,P<0.05)。结论:去甲肾上腺素联合白蛋白治疗HRS患者,有利于患者肝肾功能恢复,对HRS患者预后有一定的积极作用。Objective：To evaluate the effect of noradrenalin combined with albumin in the treatment of hepatorenal syndrome. Methods： The 153 patients in hospital with hepatorenal syndrome divided into control group and noradrenalin combined with albumin treatment group,included 36 cases type Ⅰ and 117 cases typeⅡHRS from January 2008 to December 2010, the etiopathogenisis, the total bilirubin level, the creatinine level, the MELD score, the urinary volume and the case fatality were analyzed retrospectivly. Results：After treatment in type Ⅰ HRS, there were significant difference of the creatinine level, the MELD score and the urinary volume between the control group and the treatment group （P〈0. 05）. In the treatment group, the creatinine and the MELD score were decreased, the urinary volume was increased,which were significant difference between after treatment and before treatment （P〈0. 05）. After treatment, there were significant difference of the total bilirubin level, the creatinine level, the MELD score and the urinary volume between the control group and the treatment group in type Ⅱ HRS（P〈：0.05）. In the treatment group of type Ⅱ HRS, the total bilirubin level, the creatinine and the MELD score were decreased, the urinary volume was increased, which were significant difference between after treatment and before treatment（P〈0. 05）. The difference in case fatality between the control group and the treatment group in type Ⅰ HRS（40. 0%VS 81.3%） ,were significant（χ^2 =6. 223,P〈0. 05） ; there was also significant in type Ⅱ HRS between the eonrol group and the treatment group（18. 2% VS 47. 1%, χ^2= 11. 262, P〈0. 05）. Conclusion.. The noradrenalin combined with albumin is effective in the treating hepatorenal syndrome patients.

关 键 词：肝肾综合征 MELD评分 去甲肾上腺素 白蛋白 

分 类 号：R575[医药卫生—消化系统]