特利加压素治疗肝肾综合征的疗效、预后及相关影响因素  

Efficacy and prognosis of terlipressin for hepatorenal syndrome and its related factors

作　　者：尹伟[1] 李成忠[1] 

机构地区：[1]第二军医大学附属长海医院感染科,上海200433

出　　处：《肝脏》2016年第2期100-104,共5页Chinese Hepatology

摘　　要：目的观察特利加压素治疗肝肾综合征的疗效、预后,并分析相关的影响因素及临床意义。方法回顾性分析2012年1月至2014年12月第二军医大学附属长海医院使用特利加压素治疗的肝肾综合征患者,收集治疗前及治疗后的数据,观察特利加压素的疗效及预后。根据疗效的差异和预后的不同通过单因素分析筛选可能的影响因素,进一步采用Logistic回归和ROC分析验证。结果共收集到使用特利加压素治疗肝肾综合征患者96例,特利加压素的总体有效率为43.8%,肝肾综合征I型患者有效率为32.8%,肝肾综合征Ⅱ型患者的有效率为65.6%;MELD-Na评分,基线的内生肌酐清除率,是否合并感染是特利加压素疗效的影响因素;MELD-Na评分,总胆红素和特利加压素是否有效是预后的影响因素。结论特利加压素治疗肝肾综合征疗效确切,应尽早开始治疗,对于MELD-Na评分较高的患者可能疗效较差。Objective To observe the efficacy and prognosis of terlipressin treatment in patients with hepatorenal syndrome（HRS）,and to investigate its related factors and clinical significance.Methods Data of hospitalized patients with HRS from January 2012 to December 2014 in Changhai hospital before and after terlipressin treatment was collected for analysis of the efficacy and prognosis.Univariate analysis was used to screen related factors according to varied efficacy and prognosis of HRS treated with terlipressin,analysis results of which were verified by logistic regression and receiver operating characteristic（ROC）curve analysis.Results Ninety-six HRS cases treated with terlipressin were enrolled.Among those patients,overall effectiveness was 43.8% with efficiency rate as 32.8%for HRS type I patients and efficiency rate as 65.6%for HRS type II patients.Furthermore,model for end stage liver disease Na（MELD-Na）score,baseline creatinine clearance rate（CCr）and infection incidence were related factors for efficacy of terlipressin treatment.MELD-Na score,total bilirubin（TBil）and efficacy of terlipressin treatment were related factors of prognosis.ConclusionTerlipressin has a satisfactorily curative effect on HRS treatment,efficacy and prognosis of which were associated with basis liver function before terlipressin treatment.Terlipressin should be applied as early as possible.However,efficacy may be poor in patients with higher MELD-Na score.

关 键 词：肝肾综合征 特利加压素 疗效 预后 影响因素 

分 类 号：R575[医药卫生—消化系统]