人凝血酶原复合物联合生长抑素治疗肝硬化并发上消化道出血患者的临床研究  

Clinical trial of human prothrobin complex combined with somatostatin in the treatment of patients with liver cirrhosis complicated by upper gastrointestinal bleeding

作　　者：杜妙嫣 韩阳[1] DU Miao-yan;HAN Yang(Second Department of Chengdu Station Hospital,First Affiliated Hospital of Medical College of Zhejiang University,Hangzhou 310000,Zhejiang Province,China)

机构地区：[1]浙江大学医学院附属第一医院城站院区内二科,浙江杭州310000

出　　处：《中国临床药理学杂志》2020年第9期1066-1069,共4页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察人凝血酶原复合物联用生长抑素对肝硬化(LC)并发上消化道出血患者的血流动力学和炎性因子的影响。方法将68例LC并发上消化道出血患者随机分为试验组和对照组,各34例。对照组给予奥美拉唑,每次20mg,每天2次,口服;试验组34例在对照组的基础上给予人凝血酶原复合物,用生理盐水配成100 U·mL^-1的有效消化缓冲液,口服,生长抑素用5%的葡萄糖溶液溶解,首先缓慢静脉注射250μg,而后立即以250μg·h^-1,静脉滴注。2组均治疗4周。观察2组患者的血清一氧化氮(NO)、血管紧张素转化酶(ACE)、炎症因子水平、血流动力学和凝血功能变化。结果治疗后,试验组血浆凝血酶原时间(PT)、部分凝血活酶时间(APTT)、血小板(PLT)、纤维蛋白原(FIB)分别为(12.29±3.05)s,(31.64±6.59)s,(55.46±6.59)×10^9/L,(276.26±39.47)g·L^-1,对照组分别为(17.31±3.62)s,(45.57±5.31)s,(68.51±7.28)×10^9/L,(387.81±43.58)g·L^-1,差异均有统计学意义(均P<0.05)。治疗后,2组全血高切黏度、全血低切黏度、血浆黏度、血小板聚集率、纤维蛋白原、血细胞比容差异均有统计学意义(均P<0.05)。试验组发生恶心1例,头疼1例,药物不良反应发生率为5.88%;对照组患者共发生恶心、头疼、腹胀各1例,药物不良反应发生率为8.82%。2组药物不良反应发生率差异无统计学意义(P>0.05)。结论人凝血酶原复合物联合生长抑素对LC并发上消化道出血患者具有良好的治疗效果,可以有效控制血清NO、ACE分泌,减少炎性因子分泌,显著改善患者的血流动力学指标以及凝血功能。Objective To investigate the effects of human prothrobin complex combined with somatostatin on hemorheology and inflammatory factors in patients with liver cirrhosis(LC)complicated with upper gastrointestinal bleeding.Methods Sixty-eight patients with LC complicated with upper gastrointestinal bleeding were randomly divided into treatment group and control group,34 cases in each group.Patients in control group were given omeprazole 20 mg,twice a day,orally.Patients in treatment group were given human prothrobin complex,prepared into 100 U·mL-1 of effective digestion buffer with normal saline for oral administration,dissoluted with 5%glucose solution,250μg was slowly injected intravenously at first,and then 250μg was injected intravenously every hour immediately on the basis of control group.All patients were treated for 4 weeks.The levels of serum nitric oxide(NO),angiotensin-converting enzyme(ACE),inflammatory factors,hemorheology and coagulation function were observed between the two groups.Results After treatment,the contents of plasma prothrombin time(PT),activated partial thromboplastin time(APTT),platelet(PLT),fibrinogen(FIB)in treatment group were(12.29±3.05)s,(31.64±6.59)s,(55.46±6.59)×10^9/L,(276.26±39.47)g·L^-1,all had significant difference with those in control group,which were(17.31±3.62)s,(45.57±5.31)s,(68.51±7.28)×10^9/L,(387.81±43.58)g·L^-1(all P<0.05).After treatment,the whole blood high cut,whole blood low cut,plasma viscosity,platelet aggregation rate,fibrinogen and hematocrit in two groups were all had significant difference(all P<0.05).There were 1 case of nausea and 1 case of headache in treatment group,the incidence of adverse drug reactions was 5.88%.There were 1 case of nausea,1 case of headache and 1 case of abdominal distension in control group,with the incidence of 8.82%.There was no significant difference in the incidence of adverse drug reactions between the two groups(P>0.05).Conclusion Thrombin combined with somatostatin has a good therapeutic effect on LC patients w

关 键 词：人凝血酶原复合物 生长抑素 肝硬化 上消化道出血 血流动力学 炎性因子 凝血功能 

分 类 号：R97[医药卫生—药品]