Hadengue A, Gadano A, Moreau R, Giostra E, Durand F, Valla D, Erlinger S, Lebrec D
Laboratoire d'Hémodynamique Splanchnique et de Biologie Vasculaire, INSERM and Service d'Hépatologie, Hôpital Beaujon, Clichy, France.
J Hepatol. 1998 Oct;29(4):565-70. doi: 10.1016/s0168-8278(98)80151-7.
BACKGROUND/AIMS: A treatment to induce a sustained increase in glomerular filtration rate in patients with hepatorenal syndrome has not yet been identified. Thus, the aim of the present study was to investigate the effects of terlipressin for 2 days on the glomerular filtration rate in patients with cirrhosis and hepatorenal syndrome.
A double-blind, cross-over randomized study was performed in nine patients. Patients received terlipressin (2 mg/day for 2 days) and a placebo for 2 days in a randomized order.
Terlipressin administration significantly increased creatinine clearance (from 15+/-2 ml/min to 27+/-4 ml/min) and urine output (from 628+/-67 ml/day to 811+/-76 ml/day), but did not significantly change urinary sodium concentrations. Urinary sodium excretion was not significantly different after placebo administration (0.6+/-0.1 mmol/24 h) and terlipressin administration (9.3+/-7.2 mmol/24 h). Terlipressin administration significantly decreased plasma concentrations of renin and aldosterone but not atrial natriuretic peptide levels. Placebo elicited no significant effects.
This study shows that 2-day terlipressin administration increases the glomerular filtration rate in patients with cirrhosis and hepatorenal syndrome.
背景/目的：尚未确定一种能使肝肾综合征患者肾小球滤过率持续升高的治疗方法。因此，本研究的目的是调查特利加压素治疗2天对肝硬化合并肝肾综合征患者肾小球滤过率的影响。
对9例患者进行了一项双盲、交叉随机研究。患者随机接受特利加压素（2毫克/天，共2天）和安慰剂治疗2天。
给予特利加压素后，肌酐清除率显著升高（从15±2毫升/分钟升至27±4毫升/分钟），尿量增加（从628±67毫升/天增至811±76毫升/天），但尿钠浓度无显著变化。给予安慰剂（0.6±0.1毫摩尔/24小时）和特利加压素（9.3±7.2毫摩尔/24小时）后，尿钠排泄无显著差异。给予特利加压素后，血浆肾素和醛固酮浓度显著降低，但心房利钠肽水平未降低。安慰剂无显著作用。
本研究表明，给予特利加压素2天可提高肝硬化合并肝肾综合征患者的肾小球滤过率。
