摘要
目前国内对2021年美国肝病研究学会(AASLD)修订的《肝硬化腹水和肝肾综合征诊疗指南》(下称《指南》)推荐意见出现较多争议,认为部分条款缺乏理论依据。国内有研究结果显示,限钠与负钠平衡是导致低钠血症的唯一原因,钠潴留亢进是对低钠血症应激性保护反应机制,并非限钠治疗的依据。本文辩证评估了周围循环功能障碍、肝肾综合征(HRS)发病机制与诊疗的关系,认为《指南》已削弱了临床指导意义,期待制订有中国知识产权、符合中国临床实际的腹水和HRS诊疗指南。
At pressent,there are many controversies in China about the recommendations in Diagnosis,Evaluation,and Management of Ascites,Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome(hereinafter referred to as the“Guidelines”)revised in 2021,and it's believed that some clauses lack theoretical support.Some researches in China have showed that sodium restriction and negative sodium balance are the only reason for hyponatremia.Sodium retention is the stress protective reaction mechanism for hyponatremia,not the basis for sodium restriction treatment.This article dialectically evaluates the relationship between peripheral circulation dysfunction,hepatorenal syndrome pathogenesis and diagnosis and treatment,and believes that the AASLD Guidelines have weakened the clinical guiding significance,and looks forward to the development of ascites and hepatorenal syndrome diagnosis and treatment guidelines with Chinese intellectual property rights and in line with Chinese clinical practice.
作者
刘建军
郑文凯
高廷廷
王江红
任燕军
刘建国
刘常林
LIU Jianjun;ZHENG Wenkai;GAO Tingting;WANG Jianghong;REN Yanjun;LIU Jianguo;LIU Changlin(Department of Gastroenterology,Second Hospital of Handan City,Handan,Hebei 056001,China;不详)
出处
《中国临床研究》
CAS
2023年第12期1875-1880,共6页
Chinese Journal of Clinical Research
关键词
肝硬化
腹水
肝肾综合征
周围循环障碍
限钠
指南
中国知识产权
Liver cirrhosis
Ascites
Hepatorenal syndrome
Peripheral circulation dysfunction
Sodium restriction
Guidenline
Chinese intellectual property right
