奥曲肽辅助治疗肝硬化胃底静脉曲张破裂出血患者的临床研究  

Clinical trial of octreotide in the adjuvant therapy of patients with cirrhosis and gastric varices

作　　者：周帅[1] 张剑权[1] 吕明[1] 张勇[1] ZHOU Shuai;ZHANG Jian-quan;Lü Ming;ZHANG Yong(Department of General Surgery(Hepatobiliary Pancreatic Surgery),Haikou Hospital Affiliated to Xiangya Medical College,Central South University,Haikou 570208,Hainan Province,China)

机构地区：[1]中南大学湘雅医学院附属海口医院普外一科(肝胆胰外科),海南海口570208

出　　处：《中国临床药理学杂志》2020年第14期1953-1956,共4页The Chinese Journal of Clinical Pharmacology

基　　金：海南省自然科学基金资助项目(818MS149)。

摘　　要：目的研究奥曲肽辅助内镜治疗肝硬化伴食管胃底静脉曲张破裂出血(EGVB)的疗效与安全性,及对血清胆碱酯酶、超氧化物歧化酶(SOD)、丙二醛(MDA)和胃肠道激素水平的影响。方法选取拟用内镜治疗的110例肝硬化伴EGVB患者作为研究对象,用随机数字表将患者分为试验组和对照组各55例,试验组用内镜治疗联合奥曲肽治疗(奥曲肽100μg溶解在0.9%氯化钠溶液20 mL中静推,每12 h静脉输注1次,持续3 d),对照组用内镜治疗联合生长抑素治疗(生长抑素,首剂0.25 mg缓慢静脉滴注,继而静脉微泵以0.25 mg·h^-1持续滴注,维持24 h,连用3 d)。对比2组的止血成功率、1个月内再出血率和静脉曲张消失率以及药物不良反应(ADR)发生率。结果试验组的止血成功率92.73%、1个月内再出血率7.27%和静脉曲张消失率56.36%,与对照组的87.27%,10.91%和49.09%比较,差异均无统计学意义(均P>0.05);治疗后72 h,试验组的血清胆碱酯酶为(5891.5±570.4)U·L^-1和SOD为(41.8±7.3)U·mL^-1,均明显高于对照组的血清胆碱酯酶(5449.0±538.1)U·L^-1和SOD(37.2±6.9)U·mL^-1,差异均有统计学意义(均P<0.05);试验组的MDA为(37.2±8.3)nmol·mL^-1,明显低于对照组MDA(42.7±7.6)nmol·mL^-1,差异有统计学意义(P<0.05)。试验组与对照组的ADR发生率分别为3.64%(2例/55例),10.91%(6例/55例),组间比较差异无统计学意义(P>0.05)。结论奥曲肽辅助内镜治疗肝硬化伴EGVB患者的效果可靠,对患者血清胆碱酯酶、SOD和MDA水平有一定的调节作用。Objective To investigate the effect of octreotide used in liver cirrhosis with esophageal and gastric variceal bleeding(EGVB)patients and its effect on serum cholinesterase,superoxide dismutase(SOD),malondialdehyde(MDA)and gastrointestinal hormone levels.Methods Selected 110 patients with liver cirrhosis and EGVB to be treated with endoscopy as the research object.The patients were divided into two groups according to random number table:Treatment group(100μg octreotide was dissolved in 20 mL of 0.9%sodium chloride injection and injected intravenously every 12 h for 3 d),control group(somatostatin,the first 0.25 mg slow intravenous infusion,followed by continuous intravenous infusion at 0.25 mg·h^-1,maintained for 24 h,3 consecutive days)for 3 d,55 cases in each group.The hemostatic success rate,rebleeding rate within one month,and disappearance rate of varicose veins were compared between the two groups,and incidence rates of adverse drug reaction(ADR)were compared.Results The hemostatic success rate in treatment group was 92.73%,the rebleeding rate within 1 month was 7.27%,and the varicose vein disappearance rate was 56.36%.Compared with the indicators of 87.27%,10.91%,and 49.09%in control group,the differences of the factors were not statistically significant(all P>0.05).At the time of 72 h after treatment,serum cholinesterase(5891.5±570.4)U·L^-1 and SOD(41.8±7.3)U·mL^-1 in treatment group,were higher than the serum cholinesterase(5449.0±538.1)U·L^-1 and SOD(37.2±6.9)U·mL^-1 in the control group with statistically significant(all P<0.05).MDA in treatment group was(37.2±8.3)nmol·mL^-1,it is lower than the control group(42.7±7.6)nmol·mL^-1 with statistically significant(P<0.05).The incidence of ADR in treatment group was 3.64%(2 cases/55 cases)compared with 10.91%(6 cases/55 cases)in control group,and there was no significant difference(P>0.05).Conclusion Octreotide-assisted endoscopic treatment of patients with liver cirrhosis accompanied by EGVB has a reliable effect,and has a certain regulating

关 键 词：奥曲肽 内镜治疗 肝硬化 食管胃底静脉曲张破裂出血 胆碱酯酶 

分 类 号：R97[医药卫生—药品]