Clinical Analysis of Cirrhotic Ascites Complicated with Hyponatremia_West China Medical Journal

Authors：

JIN Jun , TAN Lirang , LI Hu , YI Ming

Department of Gastroenterology, Bazhong Central Hospital, Bazhong, Sichuan 636000, P. R. China;

Corresponding author：

Keywords：

肝硬化; 腹水; 低钠血症; 肝性脑病; 肝肾综合征

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目的　探讨肝硬化腹水患者不同血清钠水平与病情严重程度的关系。方法　回顾分析2008年7月－2010年6月收治47例肝硬化腹水并发低钠血症患者，根据其入院时血清钠水平分为低钠血症轻（A组）、中（B组）、重（C组）3组。比较肝硬化腹水患者不同血钠水平的腹水程度及疗效的关系、以及低钠程度与肝性脑病、肝肾综合征和死亡发生率的关系。结果　与A组比较，B、C两组腹水量、肝性脑病、肝肾综合征及病死率明显增高，差异有统计学意义（P＜0.05）；对治疗的效果明显降低（P＜0.05）。结论　肝硬化腹水患者的血清钠水平与其病情程度具有紧密相关性，监测血清钠的水平可作为判断病情严重程度的重要指标之一，提示在临床上需重视预防、及时发现并治疗低钠血症。

Citation： JIN Jun,TAN Lirang,LI Hu,YI Ming. Clinical Analysis of Cirrhotic Ascites Complicated with Hyponatremia. West China Medical Journal, 2012, 27(9): 1325-1328. doi: Copy

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11.	刘建军, 智红, 刘芙蓉. 肝肾综合征发病机制与高渗氯化钠溶液的应用[J]. 临床肝胆病杂志, 2001, 17(1): 60-61.
12.	王娟. 肝硬化腹水并发低钠血症45例临床分析[J]. 大连大学学报, 2010, 31(6): 100-102.
13.	Guevara M, Baccaro ME, Torre A, et al. Hyponatremia is a risk factor of hepatic encephalopathy in patients with cirrhosis: a prospective study with time-dependent analysis[J]. Am J Gastroenterol, 2009, 104(6): 1382-1389.
14.	Borroni G, Maggi A, Sangiovanni A, et al. Clinical relevance of hyponatraemia for the hospital outcome of cirrhotic patients[J]. Dig Liver Dis, 2000, 32(7): 605-610.
15.	方国平, 张锁才, 孙启源, 等. 60 例肝炎后肝硬化腹水的低钠血症治疗及转归分析[J]. 肝脏, 2002, 7(1): 32-33.

1. 　陈杰, 周晓晴. 肝硬化并发急性低钠血症的临床分析[J]. 华西医学, 2006, 21(1): 134-134.
2. 　Kim JH, Lee JS, Lee SH, et al. The association between the serum sodium level and the severity of complications in liver cirrhosis[J]. Korean J Intern Med, 2009, 24(2): 106-112.
3. 　中华医学会传染病与寄生虫病学分会、肝病学分会. 病毒性肝炎防治方案[J]. 中华传染病杂志, 2001, 19(1): 56-62.
4. 　Liver EAFTSOT. EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis[J]. J Hepatol, 2010, 53(3): 397-417.
5. 　Ginès P, Jiménez W. Aquaretic agents: a new potential treatment of dilutional hyponatremia in cirrhosis[J]. J Hepatol, 1996, 24(4): 506-512.
6. 　徐晓光, 蔡洪培. 肝硬化低钠血症研究进展[J]. 中华消化杂志, 2002, 22(9): 560-562.
7. 　陈灏珠. 实用内科学[M]. 北京: 人民卫生出版社 2001: 1789.
8. 　Jenq CC, Tsai MH, Tian YC, et al. Serum sodium predicts prognosis in critically ill cirrhotic patients[J]. J Clin Gastroenterol, 2010, 44(3): 220-226.
9. 　张俊勇, 蒯京华, 秦成勇, 等. 血清钠与肝硬化并发症及其预后的关系[J]. 山东大学学报 (医学版), 2010, 48(11): 109-112.
10. 　王宇明, 陈文. 肝硬化低钠血症研究进展[J]. 肝脏, 2011, 16(2): 141-144.
11. 　刘建军, 智红, 刘芙蓉. 肝肾综合征发病机制与高渗氯化钠溶液的应用[J]. 临床肝胆病杂志, 2001, 17(1): 60-61.
12. 　王娟. 肝硬化腹水并发低钠血症45例临床分析[J]. 大连大学学报, 2010, 31(6): 100-102.
13. 　Guevara M, Baccaro ME, Torre A, et al. Hyponatremia is a risk factor of hepatic encephalopathy in patients with cirrhosis: a prospective study with time-dependent analysis[J]. Am J Gastroenterol, 2009, 104(6): 1382-1389.
14. 　Borroni G, Maggi A, Sangiovanni A, et al. Clinical relevance of hyponatraemia for the hospital outcome of cirrhotic patients[J]. Dig Liver Dis, 2000, 32(7): 605-610.
15. 　方国平, 张锁才, 孙启源, 等. 60 例肝炎后肝硬化腹水的低钠血症治疗及转归分析[J]. 肝脏, 2002, 7(1): 32-33.

West China Medical Journal

Clinical Analysis of Cirrhotic Ascites Complicated with Hyponatremia

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