低钠血症与失代偿期肝硬化患者肝脏损害程度及预后的关系  

Relationship of hyponatremia with degree of liver injury and prognosis in patients with decompensated liver cirrhosis

作　　者：郑三菊 王蕾 占国清 

机构地区：[1]湖北医药学院附属人民医院供应室,湖北十堰442000 [2]湖北医药学院附属人民医院感染性疾病科,湖北十堰442000

出　　处：《临床消化病杂志》2017年第5期271-274,共4页Chinese Journal of Clinical Gastroenterology

摘　　要：[目的]探讨失代偿期肝硬化患者血清钠水平与肝脏损害程度及预后的相关性。[方法]收集150例失代偿期肝硬化并低钠血症患者,根据其入院时血清钠水平将其分为轻度低钠组[(131~135)mmol/L]68例,中度低钠组[(121~130)mmol/L]50例,重度低钠组(≤120 mmol/L)32例。分析各组患者不同血钠水平与Child-Pugh分级、终末期肝病模型(MELD)评分、并发症发生率及生存期的关系。[结果]随着血钠水平降低,患者Child-Pugh分级和MELD分值明显增加,3组低钠血症间Child-Pugh分级和MELD分值差异均有统计学意义(P<0.01);重度低钠组肝性脑病、肝肾综合征、顽固性腹水、自发性腹膜炎发生率均高于中度低钠组和轻度低钠组,中度低钠组肝性脑病、顽固性腹水发生率也高于轻度低钠组(P<0.05或P<0.01);轻度低钠组1年、2年、3年的生存率高于重度低钠组(P<0.05或P<0.01),中度低钠组3年的生存率也高于重度低钠组(P<0.05)。[结论]低钠血症与失代偿期肝硬化患者肝损害程度、并发症及生存期密切相关,可以作为判断患者病情和预后的指标之一。[Objective]To investigate the relationship between hyponatremia and degree of liver injury and prognosis in patients with decompensated liver cirrhosis. [Methods]The total of 150 decompensated liv- er cirrhosis patients with hyponatremia in People＇s Hospital Affiliated to Hubei University of Medicine from January 2011 to December 2013 were enrolled in this study,and according to the serum sodium,these patients were divided into mild hyponatremia group（J131- 135]mmol/L,n= 68）,moderate hyponatremia group（[121-130]mmol/L, n= 50）, severe hyponatremia group（≤120 retool/L, n = 32）. The relationship between hyponatremia levels and Child-Pugh class, model for end-stage liver disease（MELD）score, compli- cations and survival time were analyzed. [Results]With the decrease of serum sodium level,the Child-Pugh and MELD score were significantly increased. There were significant difference in Child-Pugh and MELD scores among the 3 groups（P〈0.01）. The incidences of hepatic encephalopathy,hepatorenal syndrome,re- fractory ascites and spontaneous bacterial peritonitis were higher in severe group than in moderate group and mild group, the incidences of hepatic encephalopathy and refractory ascites were higher in moderate group than in mild group（P〈0.05 or P〈0.01）. The survival rates of 1,2 and 3 year were higher in mild group than in severe group（P〈0.05 or P〈0.01） ,and the 3 year survival rate of moderate group was high- er than that of severe group（P〈0.05）. [Conclusion]Hyponatremia is closely related to the degree of liver damage, complications and survival in patients with decompensated cirrhosis, and can be used as one of the indicators to judge the patient＇s condition and prognosis.

关 键 词：肝硬化 低钠血症 预后 相关性 

分 类 号：R575.2[医药卫生—消化系统]