肝硬化肝肾综合征肾功能与血氨水平的相关性研究  

The study on the correlation of renal function and plasma ammonia in patients with liver cirrhosis combined with hepatorenal syndrome

作　　者：蒋汉梅[1] 樊海宁[2] 

机构地区：[1]青海大学附属医院消化科,西宁810001 [2]青海大学附属医院肝胆胰外科,西宁810001

出　　处：《重庆医学》2013年第36期4380-4381,4384,共3页Chongqing medicine

基　　金：国家自然科学基金资助项目(30960374)

摘　　要：目的探讨分析肝硬化肝肾综合征患者肾功能与血氨水平的相关性。方法搜集该院于2008年2月至2013年4月收治的149例肝硬化患者的临床资料,根据患者是否发生肝肾综合征将所有患者分为HRS组(发生肝肾综合征,35例)与非HRS组(未发生肝肾综合征,114例)。比较两组患者的临床资料与肝肾相关的生化指标,并进行统计学分析。结果非HRS组患者肝硬化Child-Paugh分级、终末期肝病模型(MELD)评分及腹水的发生率明显优于HRS组,差异有统计学意义(P>0.05);HRS组血清总胆红素(TB)、直接胆红素(DB)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、尿素(BU)、肌酐(CREA)及NH3+的水平明显高于非HRS组,差异有统计学意义(P>0.01);总蛋白(TP)、清蛋白(Alb)、Na+、Cl-的水平明显低于非HRS组,差异有统计学意义(P>0.01);Pearson′s相关性分析结果显示:肝硬化肝肾综合征患者血清BU、CREA的水平与NH3+呈正相关(r=0.859,0.841,P<0.05)。结论肝硬化肝肾综合征患者的肾功能与患者血氨的水平密切相关,在治疗时可采用酸化肠道的方法降低肝肾综合征与肝性脑病发生的风险。Objective To study the correlation of renal function and plasma ammonia in patients with liver cirrhosis combined with hepatorenal syndrome .Methods The clinical data of 149 patients with liver cirrhosis who came to this hospital from February 2008 to April 2013 was collected .All the patients were divided into the HRS group （hepatorenal syndrome ,35 cases） and non-HRS group （non-hepatorenal syndrome ,114 cases） .The clinical datas and related biochemical indicators of two groups were analyzed and compared .Results The serum level of TB ,DB ,AST ,ALT ,BU ,CREA and NH3＋ of the HRS group was statistically higher than that of the non-HRS group ,while the serum level of TP ,Alb ,NA and CL of the HRS group was statistically lower than that of the non-HRS group;results of Pearson′s analysis showed that the serum level of BU and CREA were positively correlated with NH3＋ in HRS group .Conclusion The relationship between hepatorenal syndrome and plasma ammonia in patients with liver cir-rhosis is closely .Intestinal acidification can be used to reduce the risk of hepatorenal syndrome and hepatic encephalopathy .

关 键 词：肝硬化 肝肾综合征 肾疾病 血氨 

分 类 号：R575.2[医药卫生—消化系统]