前列地尔治疗乙型肝炎肝硬化合并肝性胸水患者的效果观察

目的 研究前列地尔注射液治疗乙型肝炎肝硬化合并肝性胸水(HH)患者的效果.方法 选取2009年1月1日至2015年1月1日在解放军白求恩国际和平医院住院的乙型肝炎肝硬化失代偿期合并HH的患者286例,按照是否接受前列地尔注射液治疗分为治疗组(164例)和对照组(122例),观察治疗4周后患者的胸水深度、腹水深度、肝肾功能、电解质水平、血常规等指标.结果 治疗4周后治疗组TBil、血肌酐(Scr)、胸水深度、腹水深度和Child-Pugh评分分别为(28.46±7.58) μmol/L、(62.83±18.36) mmol/L、(1.18-0.36)cm、(1.48±0.42) cm和(6.28±1.07),均低于对照组(43.12±10.05) μmol/L、(83.74±16.81) mmol/L、(2.74±0.64)cm、(2.39±0.61) cm和(8.74±1.36)],两组比较差异均有统计学意义(t=-3.652、-5.276、-4.326、-2.638和-2.589,P均＜0.05或0.01).治疗组PTA和血钠分别为(63.23±9.52)％和(137.16±7.17) mmol/L,均高于对照组(47.12±6.64)％、(116.34±8.42) mmol/L],两组比较差异均有统计学意义(t=6.183和3.428,P均＜0.05).治疗组患者治愈率为62.80％,明显高于对照组的39.34％,差异有统计学意义(x2=4.912,P＜0.05).结论 前列地尔注射液能有效控制肝性胸水,并且能够改善肝硬化患者的肝肾功能及血凝状态.

Observation on the effect of alprostadil for hepatitis B cirrhosis patients with hepatic hydrothorax

Objective To explore the clinical effect of alprostadil injection on hepatitis B cirrhosis patients with hepatic hydrothorax (HH).Methods A total of 286 decompensated hepatitis B cirrhosis patients with HH from Bethune International Peace Hospital were enrolled in the study from January 1st 2009 to January 1st 2015,and were divided into treatment group (n=164) and control group (n=122),according to whether accepting alprostadil injection treatment.The depths of pleural effusion and ascitic fluid,hepatorenal function,electrolytic levels and blood routine were detected after 4-week treatment.Results The levels of TBil,serum creatinin (Scr),depth of pleural effusion,depth of ascites and Child-Pugh score in the treatment group were (28.46±7.58) μmol/L,(62.83± 18.36) mmol/L,(1.18±0.36) cm,(1.48±0.42) cm and (6.28±1.07),separately,and were all lower than control group (43.12±10.05) μmol/L,(83.74±16.81) mmol/L,(2.74±0.64) cm,(2.39±0.61)cm and (8.74±1.36)].The differences had statistical significances (t=-3.652,-5.276,-4.326,-2.638 and-2.589,P all＜0.05 or 0.01).The prothrombin activity and the serum sodium in the treatment group were (63.23±9.52) ％ and (137.16±7.17) mmol/L,which were both higher than control group (47.12±6.64)％ and (116.34±8.42) mmol/L],with statistical significances (t=6.183 and 3.428,P both＜0.05).The cure rate in the treatment group (62.80％) was higher than control group (39.34％) with statistical significance (x2=4.912,P＜0.05).Conclusions Alprostadil injection can effectively control HH,and also can improve the hepatic function,renal function and coagulation status.