摘要
目的探讨尿液Na^(+)/K^(+)在病毒性肝炎肝硬化严重程度评估中的价值。方法选取住院病毒性肝炎肝硬化患者120例,其中失代偿期组55例,代偿期组65例。对两组患者尿液Na^(+)/K^(+)、肝硬化判别评分(CDS)、Child-Pugh评分及终末期肝病模型(MELD)评分进行比较;分析不同取样时间尿液Na^(+)/K^(+)与CDS、Child-Pugh和MELD评分的相关性。结果与代偿期组比较,失代偿期组上午尿液Na^(+)/K^(+)和下午尿液Na^(+)/K^(+)均显著升高(P<0.05),CDS、Child-Pugh和MELD评分均显著升高(P<0.05);而同组患者上午和下午尿液Na^(+)/K^(+)比较差异无显著性(P>0.05)。上午尿液Na^(+)/K^(+)和下午尿液Na^(+)/K^(+)与CDS、Child-Pugh及MELD评分呈正相关。上午尿液Na^(+)/K^(+)和下午尿液Na^(+)/K^(+)对于失代偿肝硬化患者诊断的灵敏度均在85%以上。上午尿液Na^(+)/K^(+)和下午尿液Na^(+)/K^(+)对诊断ROC曲线下面积差异无统计学意义。结论肝硬化严重程度可通过尿液Na^(+)/K^(+)进行评估,诊断灵敏度较好,且其灵敏度与取样时间无关。
Aim To investigate the value of urinary Na^(+)/K^(+)in the assessment of the severity of viral hepatitis and cirrhosis.Methods 120 hospitalized patients with viral hepatitis and cirrhosis were selected,including 55 cases in decompensated group and 65 cases in compensated group.Urine Na^(+)/K^(+),liver cirrhosis discrimination score(CDS),child Pugh score and end-stage liver disease model(MELD)score were compared between the two groups;the correlation between urine Na^(+)/K^(+)and CDs,child Pugh and MELD scores at different times was analyzed.Results Compared with the compensated group,the morning urine Na^(+)/K^(+)and afternoon urine Na^(+)/K^(+)in the decompensated group were significantly increased(P<0.05),but there was no significant difference in the morning and afternoon urine Na^(+)/K^(+)between the two groups(P>0.05);the scores of CDs,child Pugh and meld were significantly increased(P<0.05).Urine Na^(+)/K^(+)in the morning and urine Na^(+)/K^(+)in the afternoon were positively correlated with CDs,child Pugh and MELD scores.The sensitivity of urine Na^(+)/K^(+)in the morning and urine Na^(+)/K^(+)in the afternoon for the diagnosis of decompensated liver cirrhosis was above 85%.There was no significant difference in the area under ROC curve between morning urine Na^(+)/K^(+)and afternoon urine Na^(+)/K^(+).Conclusion The severity of liver cirrhosis can be evaluated by urine Na^(+)/K^(+),the diagnostic sensitivity is good,and its sensitivity has nothing to do with sampling time.
作者
张莉
邓立功
程倬
ZHANG Li;DENG Ligong;CHENG Zhuo(Department of Gastroenterology,Dazhou Central Hospital,Dazhou,Sichuan 635000,China)
出处
《中南医学科学杂志》
CAS
2021年第3期348-350,357,共4页
Medical Science Journal of Central South China
