肝硬化腹腔积液患者低钠血症与血管加压素和人尾加压素Ⅱ关系研究  

Correlation of Hyponatremia with Vasopressin and Human Urotensin-Ⅱ in Patients with Cirrhosis Ascites

作　　者：郭艳璞[1] 冯志杰[1] 

机构地区：[1]河北医科大学第二医院消化内科,河北省石家庄市050000

出　　处：《中国全科医学》2010年第3期237-239,共3页Chinese General Practice

摘　　要：目的测定肝硬化腹腔积液患者的血管加压素(vasopressin,VP)、人尾加压素Ⅱ(human urotensin-Ⅱ,hU-Ⅱ)水平,了解其对肝硬化低钠血症的诊断意义,并探讨低钠血症的发生机制。方法检测57例肝硬化患者和8例功能性消化不良患者的血钠、尿钠、血尿渗透压、血浆VP和hU-Ⅱ水平,并将低钠血症与Child-pugh分级、腹腔积液、肝性脑病、血尿渗透压及VP、hU-Ⅱ等指标进行相关性分析。结果肝硬化患者低钠血症发生率为41.8%。低钠血症越明显,肝功能状态越差,腹腔积液和肝性脑病的发生例数越多,血浆VP、hU-Ⅱ水平在肝硬化患者明显增加,血钠、尿钠、血渗透压、尿渗透压均与VP和hU-Ⅱ水平呈负相关(P<0.05)。尿-血渗透压比值与VP、hU-Ⅱ水平无相关性(P>0.05)。结论肝硬化患者肝功能状态越差,血钠水平越低。血浆VP、hU-Ⅱ水平增加是形成肝硬化低钠血症的机制之一,同时又能够作为判断稀释性或低钠性低钠血症的参考指标。Objective To explore the mechanism of hyponatremia and the effects of vasopressin （VP） , human urotensin-Ⅱ（ hU -Ⅱ） on cirrhosis aseites. Methods The levels of serum sodium, urine sodium, urine osmolality, plasma VP and hU -Ⅱ were determined in 57 patients with liver cirrhosis （LC） and 8 with functional dyspepsia. The correlation of hyponatremia with Child - puph grade, ascites, hepatic encephalopathy, urine osmolality and VP and hU-Ⅱ etc. was analyzed. Results The incidence of hyponatremia was 41.8% in LC patients. The more obvious hyponatremia was, the worse liver function was, and the more frequently ascites and hepatic encephalopathy occurred. Plasma VP and hU -Ⅱ increased remarkably in LC patients, and serum sodium, urine sodium, serum osmolality and urine osmolality were negatively correlated with VP, hU-Ⅱ（ P 〈 0.05 ） , but there was not correlation between urine - blood osmolality ratio and VP, hU -Ⅱ （ P 〉 0. 05 ）. Conclusion The worse the liver function is, the lower serum sodium is. The increase of serum VP, hU-Ⅱ, one of the mechanisms of cirrhosis ascites, can be regarded as a reference indicator for determination of dilution or sodium hyponatremia.

关 键 词：肝硬化 低钠血症 血管加压素 人尾加压素Ⅱ 

分 类 号：R657.31[医药卫生—外科学]