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  本文選題：奧曲肽 + 特利加壓素��； 參考：《山東大學》2014年碩士論文

【摘要】：目的：奧曲肽和特利加壓素是肝硬化患者急性靜脈曲張破裂出血(Acute variceal bleeding, AVB)的常用治療藥物。本研究的目的在于分別觀察該兩種藥物及兩者聯(lián)合對肝靜脈壓力梯度(Hepatic venous pressure gradient, HVPG)的影響。 資料與方法：49例肝硬化患者分入A(奧曲肽組)、B(特利加壓素組)、C(聯(lián)合用藥組)3組。A(奧曲肽組)給藥方式：奧曲肽O.1mg靜推(給藥時間1min),繼以25ug/h泵入,分別測在奧曲肽靜脈給藥前及給藥后1min、5min、10min、15min的WHVP、FHVP和HVPG; B(特利加壓素組)給藥方式：特利加壓素lmg靜推(2min內(nèi)完成),分別測特利加壓素靜脈給藥前及給藥后10min、20min、30min的WHVP、FHVP和HVPG值；C(聯(lián)合用藥組)給藥及觀察方式：首先靜脈給予奧曲肽,分別測奧曲肽靜脈給藥前及給藥后1min、5min、10min、15min的WHVP. FHVP和HVPG,再繼聯(lián)合給予特利加壓素靜推,分別測定聯(lián)合特利加壓素后10min、20min、30min的WHVP、FHVP和HVPG。應(yīng)用SPSS21.0統(tǒng)計學軟件分析奧曲肽和特利加壓素兩種藥物對HVPG的影響作用。 結(jié)果：A(奧曲肽組),與基礎(chǔ)HVPG相比,奧曲肽給藥后1min、5min、10min、15min HVPG變化均有統(tǒng)計學意義(P0.05),但5min、10min、15min之間無顯著差異(P0.05)。B組(特利加壓素組),與基礎(chǔ)HVPG相比,特利加壓素給藥后10min HVPG無顯著變化(P0.05),20min、30min HVPG變化則均有統(tǒng)計學意義(P0.05),20min、30min HVPG水平之間亦有顯著差異(P0.05)。C組(聯(lián)合用藥組),與奧曲肽給藥后15min HVPG相比,加用特利加壓素后10min HVPG無顯著變化(P0.05),20min、30min HVPG變化均有統(tǒng)計學意義(P0.05),20min、30min HVPG水平之間無顯著差異(P0.05)。C組療效明顯大于A、B組(P0.05),A、B組療效無顯著差異(P0.05)。 結(jié)論：奧曲肽持續(xù)給藥能很快降低肝硬化門脈高壓患者的HVPG,但很快有所回升且趨于穩(wěn)定。特利加壓素單獨應(yīng)用亦能降低HVPG,起效時間比奧曲肽慢。在奧曲肽給藥后,加用特利加壓素可進一步降低HVPG,故臨床中必要時可同時應(yīng)用兩者以加強降門靜脈壓力的作用。
[Abstract]:Objective: octreotide and telopressin are common drugs for acute variceal hemorrhage in patients with cirrhosis. The purpose of this study was to observe the effects of the two drugs and their combination on the hepatic vein pressure gradient (HVP). Materials and methods Forty-nine patients with liver cirrhosis were divided into two groups: octreotide group (Octreotide group). Group A (Octreotide group 3): octreotide 0.1 mg iv (administration time 1 min), followed by 25ug/h infusion. Before and after intravenous administration of octreotide, the levels of WHVPP-FHVP and HVPGwere measured before and 1 min 5 min and 10 min / 15 min after administration, respectively, and the administration mode of Btril vasopressin group was as follows: lmg was given intravenously within 2 minutes, and the values of lmg and HVPG were measured before intravenous administration and 10 min 20 min after administration respectively. Administration of octreotide by intravenous injection of octreotide and its observation method: the WHVPs of octreotide were measured before intravenous administration and 1 min, 5 min, 10 min and 15 min after administration of octreotide, respectively. FHVP and HVPGwere combined with Trevasopressin to determine the WHVPU FHVP and HVPG at 10 min and 20 min to 30 min after the treatment, respectively. The effects of octreotide and trivasopressin on HVPG were analyzed by SPSS 21.0 software. Results compared with basic HVPG, the changes of HVPG at 1 min, 5 min, 10 min and 15 min after administration of octreotide had statistical significance (P 0.05), but there was no significant difference between group B and group B (Trevasopressin group, compared with basic HVPG), but there was no significant difference between group A (n = 5) and group B (n = 5). There was no significant change in 10min after administration of trivasopressin. There were significant differences in the level of 10min between the two groups (P0.05, P0.05 and 30 min, compared with octreotide, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05 and C, respectively. There was no significant change in 10min after the addition of treponectin for 20 minutes or 30 minutes. There was no significant difference in the level of 10min between the two groups. There was no significant difference between the two groups. The curative effect of group C was significantly higher than that of group A (P 0.05). There was no significant difference (P 0.05) between two groups. Conclusion: continuous administration of octreotide can decrease HVPGs in patients with portal hypertension, but increase rapidly and stabilize. Treponectin alone also decreased HVPGs, and the onset time was slower than octreotide. After the administration of octreotide, the application of trivasopressin can further reduce HVPG.Therefore, both of them can be used simultaneously in clinic to enhance the effect of decreasing portal vein pressure.
【學位授予單位】：山東大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R575.2

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本文編號：2040533