The Therapeutic Effects Of Octreotide Combined With Alprostadil On Cirrhosis With Hepatorenal Syndrome

ObjectiveTo study the influences to renal function, systemic hemodynamics, portal venous hemodynamics and prognosis after treated with octreotide combined with alprostadil on patients with cirrhosis and hepatorenal syndrome, thus evaluate the efficacy and safety of this treatment.MethodsThirty nine patients diagnosed of cirrhosis with hepatorenal syndrome were divided into two groups based on the treatment program. Twenty one cases were allocated in the treatment group, with the drugs octreotide and alprostadil. Eighteen cases were allocated in the control group,with alprostadil alone. In addition, the two groups were both given a routine medical treatment, such as hepatoprotectives, diuretics, nutritional support, albumin infusion and other treatment. The changes of clinical symptoms, blood urea nitrogen, serum creatinine,24h urine output, mean arterial blood pressure, heart rate and the diameters of portal vein and splenic vein were observed after two weeks of treatment.ResultsDifferences of basic clinical features, parameters of liver and kidney function, hemodynamic parameters were not statistically significant between control and treatment group before treatment(P>0.05). In the control group, the serum creatinine level was decreased and the volume of24h urine output was increased after treatment, the differences were statistically significant (P<0.001),the blood urea nitrogen level was decreased,while the difference was not statistically significant (P>0.05). In the treatment group, the blood urea nitrogen and serum creatinine level were decreased, the volume of24h urine output was increased after treatment. Compared with the baseline, the differences were statistically significant(P<0.001). After treatment, the blood urea nitrogen and serum creatinine level in the treatment group were lower than the ones in the control group and the volume of24h urine output was higher, and the differences were statistically significant (P <0.05). Mean arterial pressure was increased and heart rate was decreased,but the differences were not statistically significant compared with the baseline in both groups (P>0.05). The diameters of portal vein and splenic vein were reduced in both groups after treatment, and the differences were statistically significant (P<0.05). After treatment, the diameters of portal vein and splenic vein in the treatment group were less than the ones in the control group, and the differences were statistically significant (P<0.05)ConclusionsAlprostadil can improve the renal function in patients diagnosed of cirrhosis with hepatorenal syndrome and can do better if combined with octreotide. Alprostadil can reduce portal pressure and can further reduce it if combined with octreotide. Both of them had no effects on systemic hemodynamics.