前列腺素E1治疗肝硬化腹水伴肝肾综合征的效果及对C反应蛋白、NO水平的影响  

Analysis on the efficacy of prostaglandin E1 on ascites due to liver cirrhosis complicated by hepatorenal syndrome and its influence on C-reactive protein and NO levels

作　　者：李慧丽 李勇 牟倩 LI Huili;LI Yong;MOU Qian(Department of Gastroenterology,Dezhou Hospital of Traditional Chinese Medicine in Shandong Province,Shandong,Dezhou 253000,China)

机构地区：[1]山东省德州市中医院消化内科,山东德州253000

出　　处：《中国医药科学》2023年第3期192-196,共5页China Medicine And Pharmacy

摘　　要：目的观察前列腺素E1对肝硬化腹水伴肝肾综合征近、远期疗效,分析其作用机制,以期找出阻断肝硬化腹水进展危险因素。方法选取2017年1月至2020年12月德州市中医院收治的肝硬化腹水伴肝肾综合征患者80例,按照随机数表法将患者分为治疗组(n=40)与对照组(n=40),对照组给予常规治疗,治疗组另加前列地尔注射液20 g+0.9%NS 100 ml静脉滴注,1次/d,4周为1个疗程。观察两组治疗后4周腹水量(B超测腹水深度)及24 h尿量、肝肾功能、肾血流及外周血C反应蛋白(CRP)、一氧化氮(NO)水平变化;随访3个月观察腹水复发率及病死率情况。结果4周后治疗组腹水量少于对照组,24 h尿量多于对照组;谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、尿素氮(BUN)、肌酐(Cr)、尿微量白蛋白指标低于对照组,白蛋白(ALB)、凝血酶原活动度(PTA)、肾血流量高于对照组;CRP、NO水平低于对照组,差异均有统计学意义(P<0.05)。随访3个月治疗组腹水复发率及病死率低于对照组,差异有统计学意义(P<0.05)。结论前列腺素E1有改善肝肾功能、增加肾血流、减轻机体炎症反应等作用,可促进腹水消退、降低病死率,对肝硬化腹水伴肝肾综合征近、远期效果良好。Objective To observe the short-term and long-term efficacy of prostaglandin E1 in the treatment of ascites due to liver cirrhosis complicated by hepatorenal syndrome,and analyze the mechanism of action,in order to find out the risk factors to block the progression of ascites due to liver cirrhosis.Methods A total of 80patients with ascites due to liver cirrhosis complicated by hepatorenal syndrome admitted to Dezhou Hospital of Traditional Chinese Medicine from January 2017 to December 2020 were selected.The patients were divided into the treatment group(n=40)and the control group(n=40)by the random number table method.The control group was given routine treatment,while the treatment group was additionally given alprostadil injection 20 g+0.9%NS 100 ml intravenous drop,once a day,with four weeks as a course of treatment.The changes of ascites fluid volume(ascites depth measured by B-ultrasound),24-h urine volume,liver and kidney functions,renal blood flow,and peripheral blood C-reactive protein(CRP)and nitric oxide(NO)levels in the two groups were observed 4 weeks after treatment.The patients were followed up for 3 months to observe ascites recurrence and mortality.Results After 4 weeks,the ascites fluid volume in the treatment group was less than that in the control group,and the 24-h urine volume was more than that in the control group.The indexes of alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),blood urea nitrogen(BUN),creatinine(Cr)and urine microalbumin as well as the CRP and NO levels in the treatment group were lower than those in the control group,while the albumin(ALB),prothrombin activity(PTA)and renal blood flow were higher than those in the control group,with statistically significant differences(P<0.05).The ascites recurrence rate and mortality in the treatment group were lower than those in the control group during 3 months of follow-up,with statistically significant differences(P<0.05).Conclusion Prostaglandin E1 can improve liver and kidney functions,increase

关 键 词：前列腺素E1 肝硬化腹水 肝肾综合征 C反应蛋白 一氧化氮 

分 类 号：R575.2[医药卫生—消化系统]