肝硬化腹水合并低钠血症患者补钠前后脑电图和智能测验比较分析  

Analysis on electroencephalogram (EEG) and Intelligence test (IT) in cirrhosis patients with ascites and hyponatremia before and after treatment of sodium replacement

作　　者：张小丽 罗冰秀 黄令霞 

机构地区：[1]湖南省血防所附属湘岳医院,湖南岳阳414000

出　　处：《中国民族民间医药》2009年第13期78-80,共3页Chinese Journal of Ethnomedicine and Ethnopharmacy

摘　　要：目的:探讨肝硬化腹水低钠血症患者脑电图(EEG)和智能测验的改变与低钠血症的关系及补钠对EEG和智能测验的影响。方法:回顾性分析67例肝硬化腹水合并低钠血症(病例组)和50例肝硬化腹水血钠正常患者(对照组)EEG和智能测验资料,病例组按血钠浓度高低分为轻度(血钠130-134mmol/L)、中度(血纳121-129mmol/L)、重度(血钠≤120mmol/L)低钠血症组三组进行EEG和智能测验结果比较。其中39例病例组进行补钠前后EEG和智能测验结果比较。结果①轻、中、重度低钠血症组脑电图异常率分别为:45.5%、73.1%、89.5%、(X2=9.556P=0.008<0.05)。②轻、中、重度低钠血症组智能测验异常率分别为:18..2%、30.8%、89.5%、(X2=23.818P=0.000<0.05)。③39例病例组补钠前28例EEG异常,补钠后14例EEG异常,差异有显著性意义(X2=4.111P=0.03<0.05)。④39例病例组补钠前智能测验异常19例,补钠后智能测验异常9例,差异有显著性意义(X2=5.571P=0.033<0.05)。结论:肝硬化腹水低钠血症患者脑电图和智能测验异常与重度低钠血症密切相关,及时补钠是减少肝性脑病发生的重要措施。Objective To find out the change of and relationship between hyponatrenia and electroencephalogram （EEG） or intelligence test （IT） , and to investigate the effect of sodium replacement on EEG and IT in cirrhosis patients with ascites and hyponatremia （CAH） . Methods Data on EEG and IT from 67 patients with CAH, test group, and 50 cirrhosis patients with ascites but without hyponatrenia （CA） , control group, were collected retrospectively. Patients with low level serum sodium in test group were divided into three subgroups according to the severity of low level of serum sodium （Na） ： light low group （LL） （Na, 130-134mmol/L） ; moderate low group （ML） （Na, 121-129mmol/L） , severe low group （SL） （Na≤ 120mmol/L） . The prevalence of abnormal EEG and IT in four subgroups was tested by Chi-square. Among them, 39 patients were received treatment of sodium replacement. EEG and IT on treated patients were compared before and after treatment. Results Prevalence of abnormal EEG were 45.5%, 73.1%, 89.5%far LL, ML, SL patients groups with CAH, respectively （X2=9.556 P=0.008 〈 0.05） .The prevalence of abnormal IT were 18.2%, 30.8%, 89.9 %for LL, ML, SL patients＇ groups , respectively （X2=23.818 P=0.000〈0.05） .Among 39 treated patients with sodium replacement, 14out of 28 patients with abnormal EEG and 10 from19 patients with abnormal IT returned to normal EEG and IT, the prevalence of abnormal EEG and IT were significantly decreased when compared before to after treatment （X2=4.111, P= 0.03 for EEG comparison, and X2=5.571, P= 0.033 ） . Conclusion abnormality of EEG and IT was related to severe hyponatremia in patients with CAH. Sodium replacement for these patients can effectively reduce the occurrence of hepatic encephalopathy.

关 键 词：肝硬化腹水 低钠血症 EEG 智能测验 异常率 

分 类 号：R575.2[医药卫生—消化系统]