特利加压素治疗失代偿期肝硬化并发低钠血症的机制和处理原则  

Mechanisms of hyponatremia in patients with decompensated liver cirrhosis treated with terlipressin and related treatment principles

作　　者：游佳[1] 江家骥[1] 

机构地区：[1]福建医科大学附属第一医院肝病中心,福州350005

出　　处：《临床肝胆病杂志》2016年第11期2191-2194,共4页Journal of Clinical Hepatology

基　　金：福建省卫生厅青年课题立项单位资助项目(2012-2-48)

摘　　要：食管胃静脉曲张出血和肝肾综合征是失代偿期肝硬化患者门静脉高压的常见并发症,特利加压素可以收缩内脏血管、降低门静脉压力、增加肾脏灌注,是一线治疗药物。近年来陆续报道了部分患者在接受特利加压素治疗期间发生了低钠血症。由于肝硬化患者本身容易发生低钠血症,使用特利加压素可能不利于患者血钠水平的管理。总结了特利加压素治疗期间低钠血症的发生率以及危险因素,主要介绍了特利加压素治疗失代偿期肝硬化患者期间低钠血症的发生机制以及低钠血症的处理原则,若能控制低钠血症的发生,特利加压素则是治疗门静脉高压并发症的有效药物。Esophagogastric variceal bleeding and hepatorenal syndrome are common complications in patients with decompensated liver cirrhosis and portal hypertension. Terlipressin can lead to the constriction of visceral vessels,reduce portal venous pressure,and increase renal perfusion and is the first- line drug. In recent years,it has been reported that some patients experienced hyponatremia during the treatment with terlipressin. Since patients with liver cirrhosis tend to develop hyponatremia,the application of terlipressin may have an adverse effect on the management of serum sodium level in such patients. This article summarizes the incidence rate of hyponatremia during terlipressin treatment and related risk factors and introduces the pathogenesis of hyponatremia during terlipressin treatment in patients with decompensated liver cirrhosis and the treatment principles for hyponatremia. If the occurrence of hyponatremia can be controlled,terlipressin may be an effective drug for the treatment of portal hypertension.

关 键 词：肝硬化 低钠血症 赖氨酸加压素 综述 

分 类 号：R575.2[医药卫生—消化系统]