Objective To investigate the efficacy of terlipressin and double- dose octreotide in reducing hepatic venous pressure gradient( HVPG) in patients with liver cirrhosis. Methods A total of 41 patients who were diagnosed with liver cirrhosis and esophageal and gastric varices in our hospital from June 2014 to March 2015 were randomly divided into terlipressin group( group A,22 patients) and octreotide group( group B,19 patients). The patients in group A were given intravenous injection of terlipressin 2 mg,and those in group B were given intravenous injection of octreotide 100 μg followed by intravenous infusion of the same drug at 50 μg / h. HVPG was measured before administration and at 10,20,and 30 min after administration,and the reduction in HVPG and changes in blood pressure and heart rate after administration were observed. The t- test was applied for comparison of continuous data between groups,and the chi- square test or Fisher's exact test was applied for comparison of categorical data between groups. Results In group A,HVPG before administration and at 10,20,and 30 min after administration was 18. 86 ± 5. 66,16. 75 ± 5. 54,16. 14 ± 5. 43,and 15. 25 ± 5. 93 mm Hg,respectively,while in group B,HVPG at the above time points was 19. 91 ± 6. 68,16. 58 ± 5. 86,17. 03 ± 6. 14,and 17. 66 ± 6. 09 mm Hg,respectively; each group showed a significant change in HPVG at each time point after administration compared with that before administration( t = 4. 010,6. 413,5. 134,5. 533,5. 741,and 4. 017,all P < 0. 05),while the reduction in HVPG after administration showed no significant differences across the two groups. The patients in both groups experienced varying degrees of reduction in heart rate and increase in blood pressure.Group A had a significantly larger reduction in heart rate compared with group B( 16. 13% ± 9. 28% vs 3. 35% ± 6. 34%; t =- 5. 062,P < 0. 001); group A had a significantly larger increase in blood pressure compared with group B( 17. 06 ± 8. 11% vs 11. 70 ± 7. 76%; t =2. 178,P = 0. 037). Conclusion Terlipressin and double- dose octreotide can effectively reduce HVPG in patients with liver cirrhosis and esophageal and gastric varices. Terlipressin can reduce HVPG more obviously over time,but terlipressin has a greater influence on heart rate and blood pressure.
检验项目参考区间是临床疾病诊断与健康监测的主要依据,参考区间的准确性、适用性直接影响着临床判断。2012年,我国卫生行业标准发布了血清AST、ALT、GGT、ALP等项目的参考区间,同时指出该参考区间可能受民族、地区影响而致其不适用,各实验室可自行建立参考区间[1]。目前建立参考区间的方法有直接法[2]和间接法[3],直接法需通过建立严格的排除标准而筛选符合要求的参考个体,且此法过程漫长繁琐、难以实施;而间接法只需通过数学统计,凭借快速简便、能得到与直接法相似结果的优势脱颖而出。本研究利用临床实验室信息系统(laboratory information system,LIS)已有数据,用数学统计模型建立AST、ALT、GGT、ALP间接法参考区间,并与国家行业标准比较,以期为临床疾病诊断与健康监测提供依据和参考。
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WANG YT, LI XW, XING DY, et al. Establishment of the reference intervals of four biochemical parameters for liver function among adults in Changchun, China based on the indirect method[J]. J Clin Hepatol, 2021, 37(9): 2161-2166. DOI: 10.3969/j.issn.1001-5256.2021.09.030.
WANG YT, LI XW, XING DY, et al. Establishment of the reference intervals of four biochemical parameters for liver function among adults in Changchun, China based on the indirect method[J]. J Clin Hepatol, 2021, 37(9): 2161-2166. DOI: 10.3969/j.issn.1001-5256.2021.09.030.