目的 探寻特利加压素联合盐酸雷尼替丁注射液治疗肝硬化上消化道出血的临床疗效。方法 回顾性纳入2023年10月—2025年10月在复旦大学附属闵行医院接受治疗的116例肝硬化上消化道出血患者，根据不同治疗方案分为对照组（58例）和治疗组（58例）。对照组iv盐酸雷尼替丁注射液，50 mg加入5%葡萄糖注射液稀释至20 mL，推注时间＞10 min，每6～8 h给药1次。治疗组在对照组基础上iv注射用特利加压素，2 mg/次，间隔4～6 h维持剂量1 mg。两组持续治疗5 d。观察两组患者临床疗效，比较两组止血相关情况、血清指标、再出血情况。结果 治疗后，治疗组患者治疗总有效率为98.28%，高于对照组的84.48%，差异有统计学意义（P＜0.05）。治疗组血压平稳时间、呕血停止时间、止血时间及住院时间均显著短于对照组（P＜0.05）。治疗后，两组患者超敏C反应蛋白（hs-CRP）、血清皮质醇（COR）、胰高血糖素（GCG）、一氧化氮（NO）水平均较治疗前显著降低（P＜0.05），且治疗组患者hs-CRP、COR、GCG、NO水平均显著低于对照组（P＜0.05）。治疗期间，治疗组再出血例数（0例）显著低于对照组（7例），差异具有统计学意义（P＜0.05）。结论 特利加压素联合雷尼替丁在治疗肝硬化合并上消化道出血患者中表现出良好的协同治疗作用，不仅能快速有效地实现止血、降低再出血风险，还有助于促进临床症状恢复，并显著改善炎症及应激相关血清学指标，且未显著增加总体不良反应。

Objective Exploring the clinical efficacy of terlipressin combined with Ranitidine Hydrochloride Injection in treatment of upper gastrointestinal bleeding due to liver cirrhosis. Methods A retrospective study included 116 patients with upper gastrointestinal bleeding due to liver cirrhosis who were treated at Minhang Hospital Affiliated to Fudan University from October 2023 to October 2025. They were divided into control group (58 cases) and treatment group (58 cases) based on different treatment regimens. Patients in control group were iv administered with Ranitidine Hydrochloride Injection, 50 mg diluted with 5% glucose injection to 20 mL, and slowly injected intravenously, with a push-in time of more than 10 min, and administered once every 6 — 8 h. Patients in treatment group were given intravenous injection of Terlipressin for injection, 2 mg per time, with a maintenance dose of 1 mg every 4 — 6 h. Both groups received continuous treatment for 5 d. The clinical efficacy of two groups was observed, and the hemostasis-related conditions, serum indicators, and rebleeding situations were compared. Results After treatment, the total effective rate of treatment group was 98.28%, which was higher than that of control group (84.48%), and the difference was statistically significant (P < 0.05). The time of stable blood pressure, the time of stopping hematemesis, the time of hemostasis, and the hospital stay in treatment group were significantly shorter than those in control group (P < 0.05). After treatment, the levels of high-sensitivity C-reactive protein (hs-CRP), serum cortisol (COR), glucagon (GCG), and nitric oxide (NO) in both groups were significantly lower than those before treatment (P < 0.05), and the levels of hs-CRP, COR, GCG, and NO in treatment group were significantly lower than those in control group (P< 0.05). During the treatment period, the number of rebleeding cases in treatment group (0 case) was significantly lower than that in control group (7 cases), and the difference was statistically significant (P < 0.05). Conclusion Terlipressin combined with ranitidine shows a good synergistic therapeutic effect in treatment of patients with upper gastrointestinal bleeding due to liver cirrhosis, not only achieves rapid and effective hemostasis, reduces the risk of rebleeding, but also helps promote the recovery of clinical symptoms, significantly improves inflammatory and stress-related serological indicators, and does not significantly increase overall adverse reactions.

R975

上海市科委青年项目（20234Y0227）