The Effects Of Octreotide,Terlipressin,and The Combination On Hepatic Venous Pressure Gradient(HVPG)in Cirrhotic Patients

Objective Octreotide is a routine treatment for acute variceal bleeding (AVB) in cirrhotic patients, as well as terlipressin. The purpose of this study was to evaluate the effects of octreotide, terlipressin and the combination, on hepatic venous pressure gradient (HVPG) in cirrhotic patients.Patients and Methods Forty-nine cirrhotic patients were divided into3groups: group A (octreotide only), group B (terlipressin only), and group C (the combination). Group A (octreotide only):Octreotide was administered250microg/h, with an initial bolus of1000microg which finished in one minute. WHVP, FHVP, HVPG were measured before drugs and at1min,5min, lOmin,15min after the start of octreotide injection. Group B (terlipressin only): Terlipressin was lmg intravenous injected (two minutes finished). WHVP, FHVP, HVPG were measured before drugs and at10min,20min,30min after the start of terlipressin injection. Group C (the combination):WHVP, FHVP, HVPG were measured before drugs and at1min,5min,10min,15min after the start of octreotide injection. Then terlipressin was lmg intravenous injected (two minutes finished). WHVP, FHVP, HVPG were measured at10min,20min,30min after the start of terlipressin injection. The effects of octreotide and terlipressin on HVPG were evaluated through SPSS21.0statistical software.Results Group A (octreotide only), compared to the basic HVPG, HVPG was markedly decreased at1min,5min,10min,15min (P<0.05), but no significant differences between HVPG at5min,10min or15min (P>0.05). Group B (terlipressin only), compared to the basic HVPG, HVPG was markedly decreased at 20min,30min (P<0.05), but not at10min (P>0.05). There were significant differences between HVPG at20min and30min (P<0.05). Group C (the combination), compared to HVPG at15min after the octreotide injection, HVPG was markedly decreased at20min、30min (P<0.05) after adding terlipressin, not at10min (P>0.05), but no significant differences between HVPG at20min,30min (P>0.05).Conclusion Continuous octreotide injection quickly caused marked reductions of HVPG in cirrhotic patients with portal hypertension, but gradually returned to a stable level despite continuous infusions of octreotide. Terlipressin injection also caused marked reductions HVPG, but worked more slowly. After octreotide, terlipressin injection caused further reduce the level of HVPG, thus octreotide and terlipressin can be used together to insure the effect of reducing portal venous pressure if necessary. The combination of two drugs was better than either.