Esrailian Eric, Pantangco Eugene R, Kyulo Namgyal L, Hu Ke-Qin, Runyon Bruce A
Division of Digestive Diseases, David Geffen School of Medicine at UCLA, USA.
Dig Dis Sci. 2007 Mar;52(3):742-8. doi: 10.1007/s10620-006-9312-0.
Type 1 hepatorenal syndrome (HRS) can be a rapidly fatal consequence of liver failure. Recent studies have utilized vasoconstrictor therapies to combat splanchnic vasodilatation. We aimed to evaluate the efficacy of a promising treatment for type 1 HRS. We compared the survival of HRS patients who received octreotide and midodrine treatment at Rancho Los Amigos Medical Center with a concurrent untreated control group of HRS patients who did not receive this treatment. Of the 81 patients, 60 were treated with octreotide/midodrine and 21 were controls. Mortality was significantly lower in the treatment group (43%) than in the controls (71%; P < 0.05). Furthermore, 24 study patients (40%) had a sustained reduction of serum creatinine compared with only 2 controls (10%; P < 0.05). This large retrospective study suggests that octreotide/midodrine treatment appears to improve 30-day survival. A randomized, controlled trial is the next important step toward evaluating this treatment modality.
1型肝肾综合征（HRS）可能是肝功能衰竭迅速导致死亡的后果。最近的研究采用血管收缩剂疗法来对抗内脏血管扩张。我们旨在评估一种有前景的1型HRS治疗方法的疗效。我们将在兰乔洛斯阿米戈斯医疗中心接受奥曲肽和米多君治疗的HRS患者的生存率与同期未接受该治疗的未治疗HRS患者对照组进行了比较。在81例患者中，60例接受了奥曲肽/米多君治疗，21例为对照组。治疗组的死亡率（43%）显著低于对照组（71%；P<0.05）。此外，24例研究患者（40%）的血清肌酐持续降低，而对照组仅有2例（10%；P<0.05）。这项大型回顾性研究表明，奥曲肽/米多君治疗似乎可提高30天生存率。随机对照试验是评估这种治疗方式的下一个重要步骤。
