特利加压素在肝硬化食管胃静脉曲张出血中的应用

李晓路; 李磊

doi:10.3969/j.issn.1001-5256.2019.10.038

特利加压素在肝硬化食管胃静脉曲张出血中的应用

DOI: 10.3969/j.issn.1001-5256.2019.10.038

李晓路,
李磊

首都医科大学附属北京佑安医院肝病消化中心

基金项目:

北京市卫生系统高层次卫生人才(2013-3-073)；十三五“艾滋病与病毒性肝炎等重大传染病防治”科技重大专项(2017ZX10203202003008)；

详细信息

中图分类号: R575.2
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- 文章访问数: 555
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- 被引次数: 0
出版历程
- 收稿日期: 2019-05-27
- 出版日期: 2019-10-20

Application of terlipressin in the treatment of esophagogastric variceal bleeding in liver cirrhosis

Li XiaoLu,
Li Lei

Department of Gastroenterology and Hepatology,Beijing YouAn Hospital,Capital Medical University

Research funding:

摘要

摘要: 食管胃静脉曲张破裂出血(EVB)是继发于肝硬化门静脉高压的一种常见致死性的并发症。特利加压素可以收缩内脏血管、降低门静脉压力、增加肾脏灌注,主要用于治疗EVB。总结了特利加压素治疗肝硬化EVB的作用机制、疗效等,认为特利加压素可有效控制EVB,且在条件允许的情况下,应优先选择特利加压素联合内镜下曲张静脉套扎术治疗EVB。
- 肝硬化 /
- 特利加压素 /
- 食管和胃静脉曲张
Abstract: Esophagogastric variceal bleeding(EVB) is a common fatal complication secondary to cirrhotic portal hypertension. Terlipressin can shrink visceral blood vessels,reduce portal pressure,and increase renal perfusion and is mainly used in the treatment of EVB. This article summarizes the mechanism of action and clinical effect of terlipressin in the treatment of EVB in liver cirrhosis and points out that if conditions permit,terlipressin combined with endoscopic variceal ligation should be the preferred treatment method for EVB.
- liver cirrhosis /
- terlipressin /
- esophageal and gastric varices

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参考文献(33)

[1] BHUTTA AQ,GARCIA-TSAO G. The role of medical therapy for variceal bleeding[J]. Gastrointest Endosc Clin N Am,2015,25(3):479-490.

[2] GARCIA-PAGAN JC,REVERTER E,ABRALDES JG,et al.Acute variceal bleeding[J]. Semin Respir Crit Care Med,2012,33(1):46-54.

[3] CHENG Y,LAN Y,JIA QB. Tenet vasopressin hemodynamics in liver cirrhosis patients with upper gastrointestinal bleeding[J]. J Clin Exp Med,2018,17(22):2419-2422.(in Chinese)程远,兰宇,贾绮滨.特利加压素对肝硬化上消化道出血患者血流动力学的影响[J].临床和实验医学杂志,2018,17(22):2419-2422.

[4] LI C,LI J,HAN T,et al. Effect of endoscopic-guided ligation combined with somatostatin on portal hemodynamics in patients with esophageal variceal bleeding[J]. Chin J Med Offic,2018,46(11):1352-1353,1355.(in Chinese)李超,李京,韩涛.内镜引导下套扎术联合生长抑素对食管静脉曲张破裂出血患者门脉系血流动力学影响[J].临床军医杂志,2018,46(11):1352-1353,1355.

[5] Chinese Society of Hepatology,Chinese Medical Association;Chinese Society of Gastroenterology,Chinese Medical Association; Chinese Society of Endoscopy,Chinese Medical Association. Guidelines for the diagnosis and treatment of esophageal and gastric variceal bleeding in cirrhotic portal hypertension[J]. J Clin Hepatol,2016,32(2):203-219.(in Chinese)中华医学会肝病学分会,中华医学会消化病学分会,中华医学会内镜学分会.肝硬化门静脉高压食管胃静脉曲张出血的防治指南[J].临床肝胆病杂志,2016,32(2):203-219.

[6] KRAG A,BORUP T,MOLLER S,et al. Efficacy and safety of terlipressin in cirrhotic patients with variceal bleeding or hepatorenal syndrome[J]. Adv Ther,2008,25(11):1105-1140.

[7] ROMERO G,KRAVETZ D,ARGONZ J,et al. Terlipressin is more effective in decreasing variceal pressure than portal pressure in cirrhotic patients[J]. J Hepatol,2000,32(3):419-425.

[8] GARBUZENKO DV. Current approaches to the management of patients with liver cirrhosis who have acute esophageal variceal bleeding[J]. Curr Med Res Opin,2016,32(3):467-475.

[9] IOANNOU GN,DOUST J,ROCKEY DC. Systematic review:Terlipressin in acute oesophageal variceal haemorrhage[J].Aliment Pharmacol Ther,2003,17(1):53-64.

[10] European Association for the Study of The Liver. EASL clinical practice guidelines for the management of patients with decompensated cirrhosis[J]. J Hepatol,2018,69(2):406-460.

[11] AUGUSTIN S,GONZALEZ A,GENESCA J. Acute esophageal variceal bleeding:Current strategies and new perspectives[J]. World J Hepatol,2010,2(7):261-274.

[12] SAUERBRUCH T,WONG F. Treatment of oesophageal varices in liver cirrhosis[J]. Digestion,2019,99(4):261-266.

[13] SATAPATHY SK,SANYAL AJ. Nonendoscopic management strategies for acute esophagogastric variceal bleeding[J].Gastroenterol Clin North Am,2014,43(4):819-833.

[14] Chinese Society of Hepatology,Chinese Medical Association.Guidelines on the management of ascites and complications in cirrhosis[J]. J Clin Hepatol,2017,33(10):1847-1863.(in Chinese)中华医学会肝病学分会.肝硬化腹水及相关并发症的诊疗指南[J].临床肝胆病杂志,2017,33(10):1847-1863.

[15] FEU F,RUIZ DAL,BANARES R,et al. Double-blind randomized controlled trial comparing terlipressin and somatostatin for acute variceal hemorrhage. Variceal Bleeding Study Group[J]. Gastroenterology,1996,111(5):1291-1299.

[16] PEDRETTI G,ELIA G,CALZETTI C,et al. Octreotide versus terlypressin in acute variceal hemorrhage in liver cirrhosis. Emergency control and prevention of early rebleeding[J]. Clin Investig,1994,72(9):653-659.

[17] SRIDHARAN K,SIVARAMAKRISHNAN G. Vasoactive agents for the management of variceal bleeding:A mixed treatment comparison network meta-analysis and trial sequential analysis of randomized clinical trials[J]. Drug Res(Stuttg),2019,69(9):487-495.

[18] FORT E,SAUTEREAU D,SILVAIN C,et al. A randomized trial of terlipressin plus nitroglycerin vs. balloon tamponade in the control of acute variceal hemorrhage[J]. Hepatology,1990,11(4):678-681.

[19] ZHOU X,TRIPATHI D,SONG T,et al. Terlipressin for the treatment of acute variceal bleeding:A systematic review and meta-analysis of randomized controlled trials[J]. Medicine(Baltimore),2018,97(48):e13437.

[20] ESCORSELL A,RUIZ DAL,PLANAS R,et al. Multicenter randomized controlled trial of terlipressin versus sclerotherapy in the treatment of acute variceal bleeding:The TEST study[J].Hepatology,2000,32(3):471-476.

[21] XIA ZX,ZHANG ZF. The efficacy of Tripsin combined growth inhibition in treatment of decompensated liver cirrhosis combined with upper gastrointestinal bleeding[J]. Drug Eval Res,2017,40(12):1745-1748.(in Chinese)夏正新,张志飞.特利加压素联合生长抑素治疗肝硬化失代偿期并急性上消化道大出血的疗效观察[J].药物评价研究,2017,40(12):1745-1748.

[22] WANG J,PENG H. Observation of terlipressin and somatostatin in the treatment of patients with fiver cirrhosis complicated by esophageal and gastric varices bleeding[J]. J Prac Hepatol,2015,18(4):418-419.(in Chinese)王军,彭浩.特利加压素联合生长抑素治疗肝硬化食管胃底静脉曲张破裂出血疗效观察[J].实用肝脏病杂志,2015,18(4):418-419.

[23] LIU DD. The effect of terlipressin combined with somatostatin in the treatment of decompensated liver cirrhosis complicated with acute hemorrhage of upper digestive tract[J]. J Bengbu Med College,2015,40(9):1164-1165,1170.(in Chinese)刘丹丹.特利加压素联合生长抑素治疗肝硬化失代偿期并急性上消化道大出血的疗效观察[J].蚌埠医学院学报,2015,40(9):1164-1165,1170.

[24] LO GH,CHEN WC,WANG HM,et al. Low-dose terlipressin plus banding ligation versus low-dose terlipressin alone in the prevention of very early rebleeding of oesophageal varices[J]. Gut,2009,58(9):1275-1280.

[25] HUNG TH,TSAI CC,TSENK GC,et al. No mortality difference following treatment with terlipressin or somatostatin in cirrhotic patients with gastric variceal hemorrhage[J]. Saudi J Gastroenterol,2016,22(3):220-225.

[26] ABID S,JAFRI W,HAMID S,et al. Terlipressin vs. octreotide in bleeding esophageal varices as an adjuvant therapy with endoscopic band ligation:A randomized double-blind placebo-controlled trial[J]. Am J Gastroenterol,2009,104(3):617-623.

[27] SEO YS,PARK SY,KIM MY,et al. Lack of difference among terlipressin,somatostatin,and octreotide in the control of acute gastroesophageal variceal hemorrhage[J]. Hepatology,2014,60(3):954-963.

[28] 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.

[29] OZEL CB,KARAMAN A,GORKEM H,et al. Terlipressin-induced ischemic skin necrosis:A rare association[J]. Am J Case Rep,2014,15:476-479.

[30] CARMO LS,BAIMA DC,BLEFARI V,et al. Involvement of the microvasculature in the pathogenesis of terlipressin-related myocardial infarction[J]. Eur Heart J Acute Cardiovasc Care,2016,5(8):505-511.

[31] YIM SY,SEO YS,JUNG CH,et al. Risk factors for developing hyponatremia during terlipressin treatment:A retrospective analyses in variceal bleeding[J]. J Clin Gastroenterol,2015,49(7):607-612.

[32] ZAKI SA. Terlipressin-induced hyponatremic seizure in a child[J]. Indian J Pharmacol,2013,45(4):403-404.

[33] HUANG Y,WANG M,WANG J. Hyponatraemia induced by terlipressin:A case report and literature review[J]. J Clin Pharm Ther,2015,40(6):626-628.

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