Clinical efficacy of terlipressin in treatment of type II hepatorenal syndrome

Objective To investigate the clinical efficacy of domestic terlipressin in the treatment of type II hepatorenal syndrome(HRS-II).Methods A total of 25 HRS-II patients admitted to our hospital from November 2011 to June 2014 were recruited into the treatment group,and 28 HRS-II patients treated with dopamine before 2011 were recruited into the control group.Patients in the treatment group were randomly divided into two subgroups: one subgroup(n = 12) was given terlipressin once every 8 h,and the other subgroup(n = 13)was given terlipressin once every 12 h.Both groups received albumin(Alb) infusion to expand the blood volume before treatment with terlipressin or dopamine,and the course of treatment was 7 days.The improvement in clinical symptoms,levels of blood urea nitrogen(BUN),serum creatinine and electrolytes,urine volume,changes in liver function,and ascites disappearance in the two groups before and after treatment were compared.Comparison of categorical data between the two groups was made by χ2test,and comparison of continuous data was made by t test.Results Patients in the control group showed no obvious symptom relief,but those in the treatment group had varying degrees of improvement in clinical symptoms.Neither group had significant changes in liver function and serum sodium level after treatment.The treatment group had significantly more patients whose ascites volume had decreased from large to medium than the control group(χ2=5.705,P < 0.05).There was a slight but not significant decrease in the levels of BUN and serum creatinine in the control group after treatment with dopamine(all P > 0.05),whereas the urine volume showed significant difference after the treatment(t = 15.534,P < 0.01).The treatment group showed significant differences in the levels of BUN and serum creatinine and urine volume after terlipressin treatment(t= 11.535,9.941,and 19.685,respectively; all P < 0.01),and significant differences in those levels were also observed compared with the control group after dopamine treatment(t = 7.317,9.284,and 9.839; all P < 0.01).Larger changes in BUN,serum creatinine,and urine volume were observed in the subgroup receiving terlipressin every 8 h than in that receiving terlipressin every 12 h,but the differences were not significant(all P > 0.05).Patients treated with terlipressin had mild and tolerable adverse reactions.Conclusion The domestic terlipressin combined with albumin infusion has good clinical efficacy and mild adverse effects in treating HRS-II.Its clinical application is highly recommended.