Hepatorenal syndrome:Response to terlipressin and albumin and its determinants
Hepatorenal syndrome:Response to terlipressin and albumin and its determinants
复制标题
肝肾综合征：对特利加压素和白蛋白的反应及其决定因素
DOI：
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发表时间：
1969
影响因子：
2.2
通讯作者：
A. A. Khan
中科院分区：
文献类型：
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作者：
Shahid Sarwar;A. A. Khan
目的：确定特利加压素和白蛋白改善肝肾综合征（HRS）患者肾功能的疗效，并确定影响疗效的因素。研究方法：在这项准实验性干预性研究中，肝硬化和HRS I型腹水患者接受静脉白蛋白治疗，并根据反应增加特利加压素剂量，最大剂量为12 mg/天。肌酐下降低于1.5 mg/dl定义为完全缓解。通过线性回归分析确定对治疗反应的预测因素。结果：共纳入24例患者，男女比例为3.8/1（19/5），平均年龄53.3（±10.06）岁。14名（58.3%）患者对特利加压素/白蛋白完全反应，7名（29.2%）患者获得部分反应，肌酸酐下降> 25%，而3名（12.5%）患者无反应。诊断时较低的血清肌酐（P值0.003）、无高钾血症（P值0.005）和无门静脉血栓形成（P值0.05）与HRS治疗反应相关。在多变量分析中，基线血清肌酐（p值0.003）是治疗应答的独立预测因子。结论：特利加压素联合白蛋白治疗HRS I型疗效确切。基线血清肌酐较低的患者更可能对该治疗有反应。
Objective: To determine the efficacy of terlipressin and albumin in improving renal functions in patient with hepatorenal syndrome (HRS) and to identify factors determinant of better response. Methods: In this quasi experimental interventional study patients of liver cirrhosis and ascites with HRS type I were treated with intravenous albumin and incremental dosage of terlipressin based on response with maximum dose of 12mg/day. Decline of creatinine below 1.5mg/dl was defined as complete response. Factors predictive of response to therapy were determined via linear regression analysis. Results: Twenty four patients were included with male to female ratio 3.8/1(19/5) and mean age 53.3 (±10.06). Complete response to terlipressin/albumin was seen in 14 (58.3%)patients, seven (29.2%) achieved partial response with > 25% creatinine decline while three (12.5%) had no response. Lower serum creatinine at diagnosis (P value 0.003), absence of hyperkalemia (p value 0.005) and absence of portal vein thrombosis (p value 0.05) are associated with response to treatment in HRS. Baseline serum creatinine (p value 0.003) was independent predictor of response to therapy in multivariate analysis. Conclusion: Terlipressin and albumin is an effective treatment for HRS type I. Patients with lower baseline serum creatinine are more likely to respond to this therapy.
影响因子：
25.7
作者：
Boyer, Thomas D.;Sanyal, Arun J.;Garcia-Tsao, Guadalupe;Blei, Andres;Carl, Daniel;Bexon, Alice S.;Teuber, Peter
通讯作者：
Teuber, Peter