慢性重型肝炎并发肝肾综合征的相关因素分析

高宝秀; 贺勇; 李贵星; 聂鑫; 罗通行; 宋昊岚

慢性重型肝炎并发肝肾综合征的相关因素分析

四川大学华西医院实验医学科

基金项目:

四川省科技支撑项目(2010SZ0252)；

详细信息

中图分类号: R575.1
计量
- 文章访问数: 3423
- HTML全文浏览量: 11
- PDF下载量: 695
- 被引次数: 0
出版历程
- 出版日期: 2011-07-20

Analysis of relationship of chronic severe hepatitis with hepatorenal syndrome

Research funding:

摘要

摘要: 目的分析慢性重型肝炎并发肝肾综合征（HRS）的发病率,研究慢性重型肝炎伴HRS患者与单纯性慢性重症肝炎患者的临床资料和血液生化指标,探讨慢性重型肝炎并发HRS的因素。方法回顾性分析我院2008年1月至2010年10月因慢性重型肝炎住院患者共450例。根据患者住院期间是否发生HRS,将研究对象分成慢性重型肝炎伴HRS（HRS组,105例）和单纯慢性重型肝炎组（非HRS组,345例）。比较两组患者的Child-Pugh分级、终末期肝病评分（MELD）、腹水发生率和血液生化指标。结果慢性重型肝炎并发HRS的院内发病率为23.3%。HRS组MELD评分为31.7±4.5,高于对照组的26.3±6.8（t=2.45,P<0.05）,腹水发生率为100%,高于对照组的33.9%（χ2=140.65,P<0.01）。HRS组Alb为（27.3±3.2）g/L,低于非HRS组（34.8±3.6）g/L（t=10.03,P<0.01）,HRS组血钠水平为（128.5±7.5）mmol/L,明显低于对照组的（137.4±6.5）mmol/L（t=4.72,P<0.01）。HRS组的...
- 肝炎,慢性 /
- 肝肾综合征 /
- 低白蛋白血症 /
- 低钠血症
Abstract: Objective To analyze the prevalence rate of hepatorenal syndrome among chronic severe hepatitis patients, to study changes of laboratory indicators and clinical condition and to discuss the relationship of hypoalbuminemia and hyponatremia with hepatorenal syndrome in patients with severe hepatitis.Methods 450 patients with severe hepatitis were enrolled.There were 105 patients with hepatorenal syndrome during hospitalization (HRS group) and 345 patients without hepatorenal syndrome (control group) .Child-pugh score, MELD, and prevalence rate of ascites among patients with and without hepatorenal syndrome was compared and difference of laboratory indicators were analyzed.Results Prevalence rate of hepatorenal syndrome among chronic severe hepatitis patients was 23.3%.MELD score among patients with hepatorenal syndrome was 31.7±4.5, which was higher than 26.3±6.8 among patients without hepatorenal syndrome (t=2.45, P<0.05) , prevalence rate of ascites was 100% in hepatorenal syndrome patients, which was higher than that (33.9%) in controls group (x2=140.65, P<0.01) .Albumin level among patients with hepatorenal syndrome was (27.3±3.2) g/L, which was lower than that (34.8±3.6) g/L among patients without hepatorenal syndrome (t=10.03, P<0.05) , sodium level was (128.5±7.5) mmol/L in HRS group, which was lower than that (137.4±6.5) mmol/L in controls group (t=4.72, P<0.01) .Total bilirubin, direct bilirubin, urea, creatine and potassium increased in patients with hepatorenal syndrome, however, total protein, albumin, sodium, chlorine decreased.Conclusion Hypoalbuminemia and hyponatremia are critical factors associated with the development of hepatorenl syndrome among patients with chronic severe hepatitis.
- hepatitis /
- chronic /
- hepatorenal syndrome /
- hypoalbuminemia

HTML全文

参考文献(12)

[1]Arroyo V, Terra C, Gines P.Advances in the pathogenesis and treatment of type-1 and type-2 hepatorenal syndrome[J].J Hepatol, 2007, 46 (5) :935-946.

[2]中华医学会.病毒性肝炎防治方案[J].中华传染病杂志, 2001, 19 (1) :56-62.

[3]Salern F, Gerbes A, Gines P, et al.Diagnosis, prevention and treatment of hepatorenal syndrome with cirrhosis[J].Gut, 2007, 56 (9) :1310-1318.

[4]Angemary B, Ceina M, Karnel F, et al.Child-Pugh versus MELD score in predicting survival in patients undergoing transjugular intrahepatic portosystemie shunt[J].Gut, 2003, 56 (2) :879-885.

[5]García-Paqan JC, Caca K, Bureau C, et al.Early use of TIPS in Patients with cirrhosis and variceal bleeding[J].N Engl J Med, 2010, 362 (25) :2370-2379.

[6]Cardenas A, Gines P.Hepatorenal syndrome[J].Clin Liver Dis, 2006, 10 (2) :371-385.

[7]Wong F, Moore K, Dingemanse J, et al.Lack of renal improvement with nonselective endothelin antagonism with tezosentan in type-2 hepatorenal syndrome[J].Hepatology, 2008, 47 (1) :160-168.

[8]Fernández J, Monteagudo J, Bargallo X, et al.A randomized unblended pilot study comparing albumin versus hydroxyethyl starch in spontaneous bacterial peritonitis[J].Hepatology, 2005, 42 (3) :627-634.

[9]Sanyal AJ, Boyer T, Garcia-Tsao G, et al.A randomized, prospective, double-blind, placebo-controlled trial of terlipressin for type1 hepatorenal syndrome[J].Gastroenterology, 2008, 134 (5) :1360-1368.

[10]Krag A, Bendtsen F, Henriksen JH, et al.Low cardiac output predicts development of hepatorenal syndrome and survival in patients with cirrhosis and ascites[J].Gut, 2010, 59 (1) :105-110.

[11]Moore KP, Aithal GP.Guidelines on the management of ascites in cirrhosis[J].Gut, 2006, 55 (Suppl 6) :vi1-12.

[12]Rssle M, Gerbes AL.TIPS for the treatment of refractory ascites, hepatorenal syndrome and hepatic hydrothorax:a critical update[J].Gut, 2010, 59 (7) :988-1000.

施引文献

资源附件(0)

访问统计