奥曲肽与特利加压素联合治疗肝硬化失代偿期患者的疗效及影响OA

Objective To investigate the efficacy of octreotide combined with terlipressin in patients with decompensated cirrhosis and its effects on coagulation function and portal system hemodynamic parameters.Methods A total of 96 patients with decompensated cirrhosis admitted to The Second People's Hospital of Xinxiang from March 2022 to March 2025 were selected and randomly assigned into group A and group B using the random number table method,with 48 patients in each group.Group A was treated with octreotide combined with terlipressin,while group B was treated with terlipressin alone.Therapeutic efficacy was evaluated after 7 consecutive days of treatment in both groups.Coagulation function indices,including prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT),and fibrinogen(FIB),were compared between the two groups.Hemodynamic indices,including hepatic venous pressure gradient(HVPG),wedged hepatic venous pressure(WHVP),and free hepatic venous pressure(FHVP),as well as portal system hemodynamic indices,including portal venous blood flow,portal vein diameter,splenic venous blood flow,and splenic vein diameter,were also compared.In addition,liver function indices,including alanine aminotransferase(ALT),aspartate aminotransferase(AST),and total bilirubin(TBil),and the incidence of adverse reactions were assessed.Results The overall response rate in group A(93.75%)was higher than that in group B(79.17%),and the difference was statistically significant(P＜0.05).After treatment,PT,TT,and APTT decreased,whereas FIB increased in both groups.Moreover,PT,TT,and APTT in group A were lower than those in group B,while FIB in group A was higher than that in group B,with statistically significant differences(P＜0.05).After treatment,HVPG,WHVP,and FHVP all decreased in both groups,and these values in group A were lower than those in group B,with statistically significant differences(P＜0.05).All portal system hemodynamic indices decreased in both groups after treatment,and the values in group A were lower than those in group B,with statistically significant differences(P＜0.05).After treatment,ALT,AST,and TBil levels decreased in both groups,and the levels in group A were lower than those in group B,with statistically significant differences(P＜0.05).The incidence of adverse reactions in group A(12.50%)was slightly higher than that in group B(6.25%),but the difference was not statistically significant(P＞0.05).Conclusion Octreotide combined with terlipressin for decompensated cirrhosis can improve liver function,coagulation function,and hemodynamic parameters,and reduce HVPG.This combined regimen shows favorable efficacy and has positive therapeutic significance for disease outcomes.