肝硬化腹水合并低钠血症的临床研究  

Clinical study on the significcance of hyponatremia in patients with cirrhotic ascites

作　　者：王慧卿[1] 林叶 严艳[1] 

机构地区：[1]大连医科大学附属第二医院消化科,辽宁大连116027

出　　处：《临床和实验医学杂志》2017年第22期2275-2278,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨肝硬化腹水合并低钠血症水平与肝性脑病、肝肾综合征、自发性腹膜炎的关系。方法回顾性分析消化内科2012年1月至2014年10月收治的108例肝硬化失代偿期伴腹患者水的病例信息,将入选患者分成轻、中、重度低钠血症组三组。观察低钠血症程度与Child-Pugh分级的关系、低钠血症程度与肝硬化并发症(肝性脑病、肝肾综合征、自发性腹膜炎)的关系,以及低钠血症程度与短期病死率的关系。结果与轻度低钠血症患者相比,中重度低钠血症患者中Child-Pugh分级程度明显增加(χ~2=17.01,P=0.00);重度低钠血症患者中肝性脑病发生率(52.63%)较轻度(18.18%)、中度(35.29%)低钠血症患者明显升高;重度低钠血症患者肝肾综合征、自发性腹膜炎发病率(52.63%,26.32%)较轻(18.18%,3.64%)、中度(35.29%,5,88%)低钠血症患者的发病率升高,差异均有统计学意义(P<0.05)。随低钠血症程度加重,患者短期病死率明显升高(χ~2=5.39,P=0.07)。结论低钠血症在一定程度上反映肝硬化患者的预后,血钠水平可作为评估肝硬化失代偿期病情严重程度的指标之一。Objective To explore the relationship between blood level of hyponnatremia and the complications of liver cirrhosis as hepatic encephalopathy,hepatorenal syndrome and spontaneous peritonitis. Methods The clinical data of 108 patients with cirrhotic ascite hospitalized in the Gastrointestinal Department of this hospital during January 2012 to October 2014 were retrospectively analyzed. All these patients were divided into three groups： mild hyponatremia group,moderate hyponatremia group and severe hyponatremia group according to the serum levels of sodium.Child-Pugh scores,the morbility of complications and the short-term mortality were analyzed. Results The degree of hyponatemia in patients with ascite caused by liver cirrhosis associated with hyponatremia was positively correlated with the complications caused by liver cirrhosis as hepatic encephalopathy,hepatorenal syndrome and spontaneous peritonitis. Conclusion Hyponatremia may seriously affect the prognosis of patients with cirrhosis,and it may be served as an indicator for evaluation of the degree of sverity of decompensation of liver cirrhosis.

关 键 词：肝硬化 腹水 低钠血症 肝性脑病 肝肾综合征 自发性腹膜炎 

分 类 号：R575.2[医药卫生—消化系统]