Efficacy of terlipressin therapy for refractory ascites in cirrhosis and type-2 hepatorenal syndrome / 临床肝胆病杂志

ObjectiveTo explore the efficacy of terlipressin therapy for refractory ascites in cirrhosis and type-2 hepatorenal syndrome (HRS-2). MethodsForty patients with refractory ascites in cirrhosis and HRS-2 who were admitted to our hospital from June 2009 to June 2014 were randomly divided into treatment group (n=23) and control group (n=17). The control group was given comprehensive medical treatment including liver protection therapy, anti-infection therapy, and nutritional support, and the treatment group was treated with terlipressin in addition to the treatment for the control group. The body weight, abdomen circumference, urine volume and urinary sodium output within 24 hours, liver and kidney function, and adverse reactions in both groups were evaluated before and after treatment. Between-group comparison of continuous data was performed by t test, and between-group comparison of categorical data was performed by χ2 test. ResultsIn the treatment group, the urine volume and urinary sodium output within 24 hours were significantly increased after treatment (270.0±120.0 vs 1200.0±490.0 ml, P＜0.05; 20.6±10.5 vs 62.5±16.5 mmol, P＜0.05), while the body weight and abdomen circumference were significantly reduced after treatment (58.5±5.3 vs 53.6±4.8 kg, P＜0.05; 97.6±7.5 vs 90.5±6.8 cm, P＜0.05). The serum levels of alanine aminotransferase, total bilirubin, blood urea nitrogen, and creatinine in the treatment group were significantly lower after treatment (P＜0.05), while the serum level of Alb in the treatment group was significantly higher after treatment (P＜005). All the above indices were significantly superior in the treatment group than in the control group (P＜0.05). The overall response rate in the treatment group was significantly higher than that in the control group (82.6% vs 52.9%, P＜0.05). There were no severe adverse reactions in both groups. ConclusionOn the basis of comprehensive medical treatment, terlipressin achieves good efficacy in the treatment of refractory ascites in cirrhosis and HRS-2 with few adverse reactions.