关键词: 特利加压素, 生长抑素, 肾功能, 肌酐, 肝硬化, 食管胃静脉曲张出血

Abstract: AIM: To assess the effect of terlipressin on renal function in cirrhotic patients with esophageal gastric varices bleeding (EGVB) and normal baseline renal function. METHODS: Ninety six cirrhotic patients with EGVB enrolled in Fujian Provincial Hospital form January 2016 to January 2019 were reviewed retrospectively. The renal function and the factors associated with serum creatinine (Cr) reduction were explored. RESULTS: The lowest serum Cr ［(58.41±14.58) μmol/L vs. (66.20±16.27) μmol/L, P=0.015］ and highest eGFR ［(105.16±19.36) mL·min-1·1.73 m-2) vs. (95.62±16.18) mL·min-1·1.73 m-2, P=0.011］ were significantly different between patients treated with terlipressin and somatostatin. Serum Cr was significantly reduced ［(65.18±17.83) μmol/L vs. (58.41±14.58) μmol/L, P=0.001］ and eGFR was significantly elevated ［(98.94±20.25) mL·min-1·1.73 m-2 vs. (105.16±19.36) mL·min-1·1.73 m-2, P<0.001］ during the use of terlipressin. Logistic regression analysis revealed that higher baseline serum Cr was a risk factor for serum Cr reduction during the use of terlipressin (OR=1.076, 95%CI 1.015-1.142, P=0.015). The reduction of serum Cr was not significant after terlipressin was discontinued ［(65.18±17.83) μmol/L vs. (63.56±13.48) μmol/L, P=0.297］. Somatostatin had no effect on serum Cr neither used or not ［(65.82±18.12) μmol/L vs. (66.20±16.27) μmol/L, P=0.766］, ［(65.82±18.12) μmol/L vs. (68.24±17.99) μmol/L, P=0.085］. CONCLUSION: Terlipressin can reduce serum creatinine and elevate eGFR of cirrhotic patients with EGVB and normal baseline renal function, and may be beneficial on preventing renal function impairment in cirrhotic patients with EGVB and normal baseline renal function.

Key words: terlipressin, somatostatin, renal function, creatinine, cirrhosis, esophageal gastric varices bleeding