摘要
目的分析并探讨乙肝肝硬化失代偿期低钠血症与并发症及临床预后的相关性。方法回顾性分析2012年1月至2015年12月年收治的273例乙型肝炎肝硬化失代偿期患者资料,血钠正常者157例,低钠血症者116例,低钠血症患者中,130mmol/L<血清Na^+<135 mmol/L 45例(A组),120mmol/L<血清Na^+≤130mmol/L 51例(B组),血清Na^+≤120 mmol/L 20例(C组),比较低钠血症组与血钠正常组理化指标、并发症及临床预后差异,分析低钠血症亚组与并发症及临床预后的相关性。结果低钠血症组ALT、AST、SCr、TBil、PT、Child-pugh评分及LSM均显著高于血钠正常组(P<0.05);低钠血症亚组间ALT、AST、SCr、TBil、PT、Child-pugh评分、LSM差异均具有统计学意义(P<0.05),Na^+水平越低,上述指标越高。低钠血症组肝性脑病、消化道出血、肝肾综合征、门静脉血栓等并发症比例均高于血钠正常组(P<0.05),低钠血症组腹水治疗达到显效比例低于血钠正常组(66.7%vs.85.7%)(P<0.05),低钠血症组患者随访期间死亡率显著高于正常组(14.7%vs.6.4%)。低钠血症亚组间血清Na^+水平与并发症发生率、随访期间死亡率呈显著负相关(P<0.05),与腹水治疗显效比例呈显著正相关(P<0.05)。结论乙肝肝硬化失代偿期患者低钠血症可增加并发症的发生,影响腹水疗效,是临床预后不良的重要标志。
Objective To analyze and explore the correlation between hyponatremia and complications as well as prognosis in hepatitis B patients with decompensated liver cirrhosis. Methods 273 cases from January 2012 to December 2015 were studied with a retrospective analysis, which included 157 cases with normal blood sodium and 116 cases with hyponatremia. The hyponatremia group was divided into three subgroups： group A had 45 cases with 130mmol/L〈 Na＋〈135 mmol/L, group B had 51 cases with 120 mmol/L〈Na＋≤130mmol/L, and group C had 20 cases with Na＋≤120mmol/L. Physicochemical indexes, complications and clinical outcomes were compared between normal group and hyponatremia group, and correlation analysis was conducted between hyponatremia and complications ＆ clinical prognosis. Results ALT, AST, SCr, TBil, PT, Child-pugh score and LSM in hyponatremia group with were significantly higher than those in normal group （P 〈 0.05）; and the differences on ALT, AST, SCr, TBil, PT, Child-pugh, and LSM scores among the three subgroups were statistically significant （P 〈 0.05）. The serum Na＋,was lower, and the indexes above were higher. Hepatic encephalopathy, gastrointestinal hemorrhage, hepatorenal syndrome, and portal vein thrombosis in hyponatremia group were higher than those in normal group （P 〈 0.05）. The ascites efficacy to significant proportion in hyponatremia group was lower than that in normal group （66.7% vs.85.7%） （P 〈 0.05）, and the mortality rate in hyponatremia patients was significantly higher than that in normal group （14.7% vs. 6.4%）. There were significantly negative correlations between the serum Na＋ level and the incidence of complications and mortality during follow-up （P 〈 0.05）. There was a significant positive correlation between the serum Na＋ level and the efficacy of ascites （P 〈 0.05）. Conclusion Hyponatremia for hepatitis B patients with decompensated cirrhosis can increase the incidence of complications and affect the therapeutic effica
出处
《标记免疫分析与临床》
CAS
2017年第10期1145-1148,1153,共5页
Labeled Immunoassays and Clinical Medicine
基金
秦皇岛市科技支撑计划项目(编号:201502A155)
关键词
肝硬化失代偿期
低钠血症
并发症
腹水
死亡率
Decompensated liver cirrhosis
Hyponatremia
Complications
Ascites
Mortality
