生长抑素、垂体后叶素与奥美拉唑三联疗法对肝硬化伴食管-胃底静脉曲张破裂出血患者胃泌素、胰高血糖素及血流动力学影响

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摘要目的探讨生长抑素、垂体后叶素与奥美拉唑三联疗法对肝硬化伴食管-胃底静脉曲张破裂出血（EGVB）患者胃泌素（GAS）、胰高血糖素（GLC）及血流动力学影响。方法选择2012年12月1日~2016年6月5日辽宁中医药大学附属医院急诊治疗的肝硬化伴EGVB患者117例，根据治疗方案分为生长抑素组、垂体后叶素组和联合组，每组各39例。生长抑素组采用生长抑素+奥美拉唑，垂体后叶素组采用垂体后叶素+奥美拉唑，联合组采用生长抑素+垂体后叶素+奥美拉唑，时间维持24~48 h。对中心静脉压、门静脉压、门静脉内径、门静脉血流速度等进行测定，采血测定GAS、GLC含量，对比两组治疗效果，同时动态监测病情变化，观察不良反应事件及处理经过。结果与治疗前比较，三组治疗后门静脉压（PVP）、门静脉内径（DPV)值、GAS、GLC含量均降低，差异均有统计学意义（P ＜ 0.05）；与垂体后叶素组、生长抑素组比较，联合组治疗后PVP、DPV值较低，GAS、GLC含量较低，差异均有统计学意义（P ＜ 0.05）；垂体后叶素组、生长抑素组改善率为74.36%、71.79%，低于联合组（92.31%）（P ＜ 0.05）；垂体后叶素组、生长抑素组的止血时间、平均输血量及住院时间均高于联合组，差异均有统计学意义（P ＜ 0.05）。结论生长抑素、垂体后叶素与奥美拉唑三联疗法可以提高肝硬化伴EGVB的止血效果，降低门脉压力、调节胃肠激素，值得广泛推广。

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	李超

关键词 ：生长抑素, 垂体后叶素, 奥美拉唑, 肝硬化, 食管-胃底静脉曲张破裂出血, 胃肠激素, 血流动力学

Abstract：Objective To investigate the effects of Somatostatin, Pituitrin and Omeprazole triple therapy in the treatment of cirrhosis with hemorrhage of gastroesophageal varices in serum GAS, GLC and hemodynamics. Methods From December 1, 2012 to June 5, 2016, 117 cases of cirrhosis with hemorrhage of gastroesophageal varices were collected in the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, according to the type of treatment, were randomly divided into Somatostatin group, Pituitrin group and combined group, with 39 cases in each group, Somatostatin group was treated with Somatostatin+Omeprazole, Pituitrin group were treated with Pituitrin+Omeprazole and the combined group were treated with Somatostatin+Pituitrin+Omeprazole, and three groups were treated for 24 to 48 h. The pressure, portal venous pressure, portal vein diameter, portal vein blood flow velocity of central vein were measured, the determination of GAS and GLC in blood samples were collected and clinical effect, dynamic changes, adverse events were compared after treatment. Results Compared with that before treatment, PVP, DPV value, GAS, and GLC of the three groups after treatment decreased, the differences were statistically significant （P < 0.05). Compared with Pituitrin group and Somatostatin group, levels of PVP and DPV were lower, GAS and GLC were lower, the differences were statistically significant （P < 0.05). The improved rate of the Pituitrin group （74.36%) and Somatostatin group （71.79%) were lower than the combined group （92.31%), the difference was statistically significant （P < 0.05). The hemostatic time, average blood transfusion and hospitalization time of the Pituitrin group and the Somatostatin group were higher than the combined group （P < 0.05). Conclusion Somatostatin, Pituitrin and Omeprazole triple therapy can improve the liver cirrhosis with esophageal and gastric variceal bleeding bleeding, reduce portal vein pressure, gastrointestinal hormone, is a kind of effective treatment.

Key words： Somatostatin Pituitrin Omeprazole Cirrhosis Gastroesophageal variceal Bleeding Gastrointestinal hormones Hemodynamics

作者简介: 李超（1984.2-），男，硕士；研究方向：消化疾病的临床诊疗。

引用本文:

李超. 生长抑素、垂体后叶素与奥美拉唑三联疗法对肝硬化伴食管-胃底静脉曲张破裂出血患者胃泌素、胰高血糖素及血流动力学影响[J]. 中国医药导报, 2018, 15(13): 67-71.
LI Chao. Study on the effects of Somatostatin, Pituitrin and Omeprazole triple therapy in the treatment of cirrhosis with hemorrhage of gastroesophageal varices in serum GAS, GLC and hemodynamics. 中国医药导报, 2018, 15(13): 67-71.

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[1] Toshikuni N，Takuma Y，Tsutsumi M. Management of gastroesophageal varices in cirrhotic patients： current status and future directions [J]. Ann Hepatology，2016，15（3）：314.
[2] Rockey DC，Elliott A，Lyles T. Prediction of esophageal varices and variceal hemorrhage in patients with acute upper gastrointestinal bleeding [J]. J Investig Med，2016， 64（3）：745.
[3] Lo EA，Wilby KJ，Ensom MH. Use of proton pump inhibitors in the management of gastroesophageal varices：a systematic review [J]. Ann Pharmacother，2015，49（2）：207-219.
[4] Wang C，Han J，Xiao L，et al. Efficacy of vasopressin/terlipressin and somatostatin/octreotide for the prevention of early variceal rebleeding after the initial control of bleeding： a systematic review and meta-analysis [J]. Hepatol Int，2015，9（1）：120.
[5] Chen YQ，Liu HS，Li WX，et al. Efficacy of transvaginal debridement and repair surgery for cesarean scar pregnancy：a cohort study compared with uterine artery embolism [J]. Int J Clin Exp Med，2015，8（11）：21187.
[6] 张京，刘霄岩.奥美拉唑联合奥曲肽治疗肝硬化出血疗效观察[J].中国误诊学杂志，2012，12（3)：532-532.
[7] 王吉耀.肝硬化门脉高压食管胃静脉曲张出血的防治[J].实用肝脏病杂志，2013，16（3）：195-197.
[8] Wu CK，Liang CM，Hsu CN，et al. The Role of Adjuvant Acid Suppression on the Outcomes of Bleeding Esophageal Varices after Endoscopic Variceal Ligation [J]. PLoS One，2017，12（1）：e0169884.
[9] Xin CS，Gao BL，Yao YY，et al. Value of the Left Gastric Vein in Predicting Esophagogastric Variceal Bleeding of Cirrhosis Evaluated with Multi-Detector Computed Tomography [J]. J Med Imaging & Health Informatics，2017， 7（6）：1253-1256.
[10] Gotlib JP. Endoscopic Obturation of Esophageal and Gastric Varices with a Cyanoacrylic Tissue Adhesive [J]. 2016， 4（9）：637-638.
[11] Morrison J，Mendoza-Elias N，Lipnik A，et al. 3：27 PMAbstract No.384-Gastric varices bleed at lower portosystemic pressure gradients than esophageal varices [J]. J Vascular & Int Radiology，2017，28（2）：S166.
[12] Sauerbruch T，Mengel M，Dollinger M，et al. Prevention of Rebleeding From Esophageal Varices in Patients With Cirrhosis Receiving Small-Diameter Stents Versus Hemodynamically Controlled Medical Therapy [J]. Gastroenterology，2015，149（3）：660.
[13] Li SB，Li XJ，Gastroenterology DO. Clinical effects of endoscopic treatment of esophageal and gastric variceal bleeding [J]. World Chinese Journal of Digestology，2015，23（19）：3136.
[14] Wong GL，Espinosa WZ，Wong VW. Personalized management of cirrhosis by non-invasive tests of liver fibrosis [J]. Clin Mol Hepatol，2015，21（3)：200-211.
[15] Alempijevi■ T，Balovi■ A，Pavlovi■markovi■ A，et al. Efficacy of long-acting somatostatin analogs in recurrent variceal bleeding in a patient with pre-hepatic portal vein thrombosis [J]. Vojnosanitetski Pregled，2015，72（3）：283-286.
[16] Hung TH，Tsai CC，Tseng CW，et al. No difference in mortality between terlipressin and somatostatin treatments in cirrhotic patients with esophageal variceal bleeding and renal functional impairment [J]. Eur J Gastroenterol Hepatol，2016，28（11）：1275-1279.
[17] Mahmoud HS，Ghweil AA，Bazeed SE，et al. Reliability of Plasma Von Willebrand Factor Antigen in Prediction of Esophageal Varices in Patients with Liver Cirrhosis [J]. Open Journal of Gastroenterology，2015，5（6）：49-57.
[18] Abraldes JG，Dell'Era A，Bosch J. Medical management of variceal bleeding in patients with cirrhosis [J]. Can J Gastroenterol 2016，18（2）：109-113.
[19] Kapoor A，Dharel N，Sanyal AJ. Endoscopic Diagnosis and Therapy in Gastroesophageal Variceal Bleeding [J]. Gastrointestinal Endoscopy Clinics of North America，2015，25（3）：491.