摘要
Abstract
Objective To investigate the changes in prognosis, serum cholinesterase levels, and oxidative stress of liver cirrhosis patients with gastrointestinal bleeding treated with vitamin C combined with octreotide. Methods In total, 66 patients with liver cirrhosis and gastrointestinal bleeding who were treated at First People's Hospital of Neijiang between January 2014 and June 2016 were selected and randomly divided into a study group and control group, with 33 cases in each group. The control group was treated with octreotide as a routine treatment, and the study group was given an intravenous drip of 3 g of vitamin C daily in addition to octreotide. All patients were treated until hemostasis. The efficacy and mortality during hospitalization, as well as the levels of serum cholinesterase, superoxide dismutase (SOD), and malondialdehyde (MDA) before hospitalization and on days 1-3 of treatment, were statistically compared between the two groups. Results Following treatment, there were 25 remarkable cases (75.7%), six effective cases (18.2%), and two ineffective cases (6.1%) in the study group, and 16 remarkable cases (48.5%), eight effective cases (24.2%), and nine ineffective cases (27.3%) in the control group, which reflects a more significantly curative effect in the study group compared with the control group (u=-2.487, P=0.013). The mortality rate of the study group was lower than that of the control group 〔6.1% (2/33) vs. 27.3% (9/33), χ2=5.345, P=0.021〕. There was intervention between the treatment method and time in the levels of serum cholinesterase, SOD, and MDA (P< 0.05). The effect of treatment on the levels of serum cholinesterase, SOD, and MDA levels was significant (P<0.05). Time also exhibited significant effects on serum cholinesterase, SOD, and MDA levels (P<0.05). There were no significant differences in serum cholinesterase, SOD, and MDA levels between the two groups before treatment and on day 1 following treatment (P>0.05). The levels of serum cholinesterase and SOD in the study group on day 2 and 3 following treatment were higher than those in the control group, while the level of MDA was lower than that of the control group (P<0.05). The levels of serum cholinesterase and SOD in the study group on days 1-3 after treatment were higher than those before treatment, while the levels of MDA were lower than those before treatment (P<0.05). The levels of serum cholinesterase and SOD in the control group on days 2-3 after treatment were higher than those before treatment, while the level of MDA was lower than that before treatment (P<0.05). Spearman correlation analyses showed that the levels of serum cholinesterase, SOD, and MDA in the study group before and after treatment were correlated with efficacy and prognosis (P<0.05). Conclusion Vitamin C combined with octreotide in the treatment of cirrhosis and gastrointestinal bleeding can significantly improve efficacy and prognosis by increasing the levels of serum cholinesterase and SOD and reducing the level of MDA. The levels of serum cholinesterase, SOD, and MDA are related to the efficacy and prognosis, and may be used as reference indices for evaluation of the curative effect, which could guide clinical intervention and improve treatment as well as prognosis.关键词
肝硬化/胃肠出血/抗坏血酸/奥曲肽/预后/胆碱酯酶/氧化应激Key words
Liver cirrhosis/Gastrointestinal hemorrhage/Ascorbic acid/Octreotide/Prognosis/Cholinesterase/Oxidative stress分类
医药卫生
