Observation on the therapeutic effect of low-dose Dopamine combined with tolvaptan in the treatment of Hepatorenal syndrome
Objective To observe the therapeutic effect of low-dose dopamine combined with tolvaptan in the treatment of hepa-torenal syndrome.Method 90 HRS patients from the First Affiliated Hospital of Henan University were randomly divided into groups A,B,and C.Three groups received routine treatment.Group A was treated with an additional dose of tolvaptan once a day for 7 days;Group B was treated with dopamine at a continuous dose of 3ug/(kg·min)for 7 days;Group C was treated with a combination of tolvap-tan and dopamine.The changes or improvements in urine volume、blood creatinine and sodium、portal vein diameter、abdominal cir-cumference and related symptoms of the three groups of patients before and after treatment were compared.Result Before and after treatment,the urine volume,blood sodium,blood creatinine,portal vein main diameter and abdominal circumference of Group A pa-tients were 637±86.35ml/789±69.35ml,120±5.1mmol/L/122±3.6mmol/L,353±65.37umol/L/313±45.21umol/L,14.87±1.56mm/14.21±1.08mm,99±3.21cm/92±3.39cm,respectively;The urine volume,blood sodium,blood creatinine,portal vein main diameter and abdominal circumference of patients in Group B before and after treatment were 663±78.12ml/769±58.12ml,121±3.9mmol/L/124±5.1mmol/L,365±59.65umol/L/295±46.25umol/L,15.19±1.41mm/14.25±1.35mm,98±3.96cm/93±3.39cm,re-spectively;Before and after treatment,the urine volume,blood sodium,blood creatinine,portal vein main diameter and abdominal cir-cumference of group C patients were 678±83.35ml,1025±98.35ml,121±4.7mmol/L/126±5.3mmol/L,349±61.28umol/L/189±49.38umol/L,15.12±1.87mm/12.35±2.98mm and 97±2.91cm/85±3.09cm,respectively.After treatment,patients in Group C showed a significant increase in urine output,a significant increase in blood sodium,a significant decrease in blood creatinine,and a significant decrease in the diameter and abdominal circumference of the main portal vein,with statistically significant differences.Con-clusion The combination of low-dose dopamine and tolvaptan in the treatment of hepatorenal syndrome can effectively improve renal function and blood indicators,and alleviate symptoms.
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