血清钠对肝硬化并发症及预后的影响  

Effect of Serum Sodium on Complications and Prognosis of Liver Cirrhosis

作　　者：王崇慧[1] 郑三菊[1] 占国清[1] 

机构地区：[1]湖北医药学院附属人民医院肝病科,十堰442000

出　　处：《临床消化病杂志》2012年第4期230-233,共4页Chinese Journal of Clinical Gastroenterology

摘　　要：目的探讨血清钠水平与失代偿期肝硬化患者并发症及预后的关系。方法 225例失代偿期肝硬化患者,根据其入院时血清钠水平分低钠血症轻、中、重度组和血清钠正常组,分析患者血清钠水平与终末期肝病模型(MELD)、Child-Pugh分级、并发症发生率及预后的关系。结果在235例患者中,低钠血症发生率为54.04%。血清钠水平越低,患者MELD、Child-Pugh分级越高;除消化道出血外,其它并发症如肝性脑病、自发性腹膜炎、低钾血症、肝肾综合征发生率越高;患者腹水程度越严重。血钠正常组、低钠血症轻、中、重度组病死率分别为7.09%、12.77%、28.95%、60.87%,中、重度组病死率明显高于血钠正常组。重度组病死率也高于中、轻度组(P<0.01)。结论低钠血症与失代偿期肝硬化患者MELD、Child-Pugh分级、并发症及预后密切相关,监测血清钠水平可作为判断肝硬化患者预后的指标之一。Objective To explore the relationship between serum sodium and complications and prognosis in patients with decompensation liver cirrhosis. Methods 235 decompensation cirrhosis patients were divided into light, moderate, severe hyponatremia groups and serum sodium normal group according to their serum sodium levels. The relationship between serum sodium levels and end- stage liver disease （ MELD ）, Child- Pugh classification, incidences of complications and prognosis were analyzed respectively. Results In 235 patients, the incidence of hyponatremia was 54.04%. The lower serum sodium levels, the higher patients＇ MELD,Child-Pugh classifications and higher incidences of other complications including hepatic encepha- lopathy, spontaneous bacterial peritonitis, hypokalemia, hepatorenal syndrome except for gastrointestinal bleeding, the more se- vere patients＇ aseites extent. The mortality in serum sodium normal group and light, moderate, severe hyponatremia groups was 7.09% , 12.77% ,28.95% ,60.87% respectively, the mortality in severe hyponatremia group was significantly higher than that in moderate,light hyponatremia groups and serum sodium normal group, the mortality of moderate hyponatremia group was also significantly higher than that of serum sodium normal group （ P 〈 0. 01 ）. Conclusion The hyponatrelnia closely correlate with MELD and Child-Pugh classifications, complications and prognosis in patients with decompensation liver cirrhosis, which sug- gests its monitoring can be one of the prognostic predictors in patients with liver cirrhosis.

关 键 词：肝硬化 血清钠 并发症 预后 

分 类 号：R575.2[医药卫生—消化系统]