Efficacy Of Terlipressin Combined Alprostadil Treatment Of Liver Cirrhosis With Refractory Ascites

Purpose: Investigate the effects of terlipressin combined alprostadil symptoms,renal function systemic hemodynamic effects on portal systemic hemodynamics, inorder to evaluate the effectiveness and safety of this combined method.Methods:42cases with liver cirrhosis, which accompanied by randomly dividedinto treatment group and control group.22cases in the refractory ascites treatmentgroup, applied with ofterlipressin and alprostadil, while20cases in the controlgroup,prescribed with alprostadil only. restriction of salt and water, other foundationtreatment like:liver protection,diuresis, nutritional support,supplement of albumin andother symptomatic treatment,were same.The course of treatment was2weeks.Alprostadil. l0ug,qd,iv,terlipressin1mg, q8h, iv. indicators with including,24h, urinevolume, waist circumference, ascites depth, urea nitrogen,serum creatinine, meanarterial pressure, heart rate, diameter of portal vein and splenic vein indexes,wascarefully dictated after treatment.Results:1.General informationBefore treatment, there was no significant significance in age, weight, sex, cause,Child-Pugh grading and assessment, albumin, total bilirubin, renal function, blood coagulation function, mean arterial pressure, heart rate, bloodsodium concentration,diameter of portal vein and splenic vein,ascites depth comparison, between the.twogroups.2.Comparison of indexes of renal function before and after treatmentIn the treatment group,BUN and SCr decreased after treatment,there existedsignificant difference (P<0.05). At the same time in the control group,BUN and SCralso reduced (P<0.05), it was significally different. after treatment, SCr in two groupsexisted difference,which is statistically significant(P<0.05), while the differences inBUN between the.two groups made no sense (P>0.05).3.Comparison of urine volume, ascites depth before and after treatmentIn the treatment group,urine volume increased, abdominal circumference reducedand ascites depth lowered,after treatmen,compared with those statistics before thetreatment, it was statistically significantt(P<0.05). The same Phenomenon exhibited inthe control group. After treatment, the difference in the above three indicators betweentwo groups presented significancet(P<0.05).4.Comparison of portal vein and splenic vein diameterIn the treatment group, the diameter of portal vein and splenic vein reduced, thedifference was statistically significant (P<0.05). In the control group,portal vein andsplenic vein were not significantly reduced, no significant difference (P>0.05).5.Variation in two groups of hemodynamic indexes (MAP and HR) before and aftertreatmentthe treatment group and the control group had no significant change, no statisticalsignificance exisited in the MAP and HR (P>0.05).Conclusion:1.Terlipressin combined with alprostadil in treating refractory ascitesdue to cirrhosis can lower portal pressure, improve renal function, increase urinevolume, and reduce the ascites, alprostadil.solely.2.Outruns the effects of salprostadil alone can improve renal function,urine volume, but can not decrease the pressure of portal vein. 3.Terlipressin has minor effects on blood pressure, heart rate.