【摘要】 目的观察多巴胺联合特利加压素治疗Ⅰ型肝肾综合征的临床疗效。方法采用回顾性研究根据入院时间将63例Ⅰ型肝肾综合征患者根据肝硬化Child-pugh评分随机分为三组,三组患者在年龄、性别及临床症状、体征及肝肾损害方面均有可比性,三组患者治疗前血肌酐(Cr)、尿素氮(BUN)、Na+比较差异无统计学意义。其中多巴胺治疗组21例(Ⅰ组),多巴胺联合特利加压素治疗组21例(Ⅱ组),常规治疗对照组21例(Ⅲ组)。比较三组治疗前后临床治愈好转率,并观察Cr、BUN、Na+、K+定量检测指标的变化。结果治疗后Ⅰ组总有效率为33.3%(7/21),Ⅱ组总有效率为71.4%(15/21),Ⅲ组总有效率为28.6%(6/21)。Ⅰ组与Ⅲ组比较差异无统计学意义(χ2=0.14,P>0.05);Ⅱ组疗效优于Ⅰ组(χ2=8.00,P<0.05)与Ⅲ组(χ2=9.56,P<0.05),差异有统计学意义;Ⅱ组治疗结束后肾功能明显好转,电解质紊乱纠正,检测Cr、BUN、Na+与Ⅲ组比较差异有统计学意义(t1=2.45,t2=3.56,t3=2.67,P<0.05)。结论多巴胺联合特利加压素治疗Ⅰ型肝肾综合征有较好疗效。更多还原

【Abstract】 Objective To observe the clinical efficacy of dopamine combined with terlipressin for the treatment of type Ⅰ hepatorenal syndrome. Methods According to child-pugh scores,63 patients with hepatorenal syndrome type Ⅰ were randomly divided into three groups,There was no significant difference between the three groups in age,sex and clinical symptoms and liver and kidney damnification( P > 0. 05),Cr,BUN,Na+of three groups before treatment showed no significant difference( P > 0. 05). 21 patients were treated with dopaminergic( group Ⅰ),21 patients were treated with dopamine combined with terlipressin( group Ⅱ),other 21 patients were treated with conventional therapeuic schedule( groupⅢ).Clinical cure rates and amelioration rates of three groups were compared,and the changes of Cr,BUN,Na+,K+before and after treatement were observed. Results The total effective rates of three groups were was33. 3%( 7 /21),71. 4%( 15 /21) and 28. 6%( 6 /21). There was no significant difference between GroupⅠand Group Ⅲ( P > 0. 05); the effective rate of group Ⅱ was significantly higher than group Ⅰ( χ2= 8. 00,P < 0. 05) and group Ⅲ( χ2= 9. 56,P < 0. 05); the renal function of patients in group Ⅱ improved significantly after treatment and electrolyte imbalances were corrected,the differences of Cr,BUN,Na+between group Ⅱ and Ⅲ were statistically significant( t = 2. 45,P < 0. 05; t = 3. 56,P < 0. 05; t = 2. 67,P < 0. 05). Conclusions The curative effect of Dopamine combined with terlipressin for type Ⅰ hepatorenal syndrome is very notable.更多还原