血浆尾加压素Ⅱ与2型肝肾综合征患者预后关系研究  

Relationship between Plasma Urotensin Ⅱ and Prognosis of Patients with Type 2 Hepatorenal Syndrome

作　　者：李东 夏晨梅 张忠臣 颜海帆 

机构地区：[1]浙江省温岭市第一人民医院消化科,317500

出　　处：《中国全科医学》2014年第29期3505-3507,共3页Chinese General Practice

摘　　要：目的探讨血浆尾加压素Ⅱ与2型肝肾综合征(HRS)患者预后的关系。方法选取2009年1月—2013年1月在温岭市第一人民医院住院、已明确诊断为2型HRS的患者78例,患者入院后即开始随访,随访时间为3个月。若患者在随访期间死亡,则纳入死亡组,否则纳入存活组。对比分析两组患者性别、年龄、合并症、终末期肝病模型(MELD)评分、实验室检查〔包括丙氨酸氨基转移酶(ALT)、总胆红素、清蛋白、血肌酐、白细胞计数、血红蛋白、血小板计数、C反应蛋白、血浆尾加压素Ⅱ及国际标准化比率(INR)〕等。采用时间依存风险比例模型探讨2型HRS患者预后的影响因素。结果随访3个月时,存活组31例,死亡组47例。两组性别、年龄、消化道出血、肝性脑病、脓毒症、ALT、清蛋白、白细胞计数、血红蛋白、血小板计数、C反应蛋白和INR比较,差异均无统计学意义(P>0.05)。死亡组总胆红素、血肌酐、血浆尾加压素Ⅱ和MELD评分均高于存活组(P<0.01)。时间依存风险比例模型结果显示,血浆尾加压素Ⅱ、总胆红素和MELD评分均是2型HRS患者预后的影响因素(P<0.05)。结论血浆尾加压素Ⅱ升高提示2型HRS患者预后不良。Objective To explore the relationship between plasma urotensin Ⅱ and the prognosis of patients with type2 hepatorenal syndrome（ HRS）. Methods From January 2009 to January 2013,in the First People＇s Hospital of Wenling,78 type 2 HRS patients had follow- up after admission,for 3 months. The patients who died during follow- up were enrolled in death group,those who did not die were enrolled in survival group. Patients＇ gender,age,complications,scores of model of end- stage liver disease（ MELD）,laboratory examinations were contrasted. The laboratory examinations included ALT,total bilirubin（ TBiL）,albumin（ AL）,creatinine（ Cr）,white blood cell（ WBC）,hemoglobin,platelet,C- reactive protein（ CRP）,urotensin Ⅱ and international normalized ratio（ INR）. To explore the factors influencing type 2 HRS patients＇ prognoses,time- dependent proportional hazard model was used. Results After 3 months follow- up,there were 31 patients in survival group,47 in death group. There was no significant difference in gender,age,gastrointestinal bleeding,hepatic encephalopathy,sepsis,ALT,AL,WBC,hemoglobin,platelets,CRP,INR between 2 groups（ P 0. 05）. TBiL,Cr,urotensin Ⅱ,MELD scores were higher in death group than in survival group（ P 0. 01）. Time- dependent proportional hazard model showed that urotensin Ⅱ,TBiL,MELD scores were the factors influencing the prognoses of type 2 HRS patients（ P 0. 05）. Conclusion Elevated urotensin Ⅱ suggests poor prognoses of type 2 HRS patients.

关 键 词：肝肾综合征 预后 血浆尾加压素Ⅱ 

分 类 号：R575.34[医药卫生—消化系统]