摘要
目的探讨肝硬化失代偿期患者不同血清钠水平与病重程度的关系。方法回顾性分析我科收治的145例肝硬化腹水伴低钠血症患者,根据其入院时血清钠水平分为低钠血症轻、中、重度组,对所有患者分别进行终末期肝病模型(MELD)及Child-Pugh评分,观察其并发症和预后。结果患者低钠血症程度愈重,其MELD和Child-Pugh分值愈高,3组间比较均有显著性差异(P<0.01)。重度组在肝性脑病、肝肾综合征、低钾血症、顽固性腹水发生率及死亡率方面均明显高于中度组和低度组(P<0.05,P<0.01)。中度组在肝性脑病、顽固性腹水发生率及死亡率方面也明显高于低度组(P<0.05,P<0.01)。中度组在肝性脑病、顽固性腹水发生率及死亡率方面也明显高于低度组(P<0.05,P<0.01)。结论肝硬化失代偿期患者的血清钠水平与其病重程度相关,监测血清钠水平可作为判断肝硬化腹水病情严重程度的重要指标之一。
Objective To explore the relationship between different serum sodium level and severity of the diseases in decompensation cirrhosis patients. Methods 145 cirrhosis ascites patietns with hyponatremia were analyzed retrospectively. The patients were divided into mild, moderate and severe hyponatremia groups according to their serum sodium levels and graded with MELD formula and Child-Pugh respectively, their complications and prognosis were observed. Results The more severe patients＇ hyponatremia, the higher their MELD and Child-Pugh scores. There were significantly different in MELD and Child-Pugh scores among the three groups（ P 〈 0. 01 ）. The severe hyponatremia group was significantly higher than the moderate and low hyponatremia groups in hepatic encephalopathy, hepatorenal syndrome, hypokalemia, refractory ascites incidence and mortality（ P 〈 0. 05, P 〈 0. 01 ）, the moderate hyponatremia group was also significantly higher than the lower one in hepatic encephalopathy, refractory ascites incidence and mortality（ P 〈 0. 05, P 〈 0. 01 ）. Conclusion The levels of serum sodium for decompensation cirrhosis patients are interrelations to the severity of their condition, monitoring of serum sodium levels can be used as one of important indicators to determine the extension of severity in patients with cirrhotic ascites.
出处
《临床消化病杂志》
2009年第5期296-298,共3页
Chinese Journal of Clinical Gastroenterology
