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肝硬化患者稀释性低钠血症的研究现状与展望

胡玉琳 全香兰

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肝硬化患者稀释性低钠血症的研究现状与展望

详细信息
  • 中图分类号: R575.2

Research state and prospect of hyponatremia in cirrhosis

  • 摘要: 稀释性低钠血症(DH)是肝硬化腹水患者常发生的一个并发症,并与难以控制的腹水、肝性脑病(HE)、自发性细菌性腹膜炎(SBP)及肝肾综合征(HRS)密切相关。肝硬化患者DH,轻者可表现为疲乏无力、肌张力低,重者可出现低钠性脑病,表现为认知、运动功能障碍,严重者可出现抽搐或昏迷。肝移植前存在DH的患者,其移植后的并发症和病死率明显增加。治疗上限制水摄入、输入白蛋白以纠正DH,严重低钠血症,静脉补充高张钠。几种非肽V2受体拮抗剂有望在肝硬化患者DH的治疗上发挥一定的作用。

     

  • [1]Angeli P, Wong F, Watson H, et al.Hyponatremia in cirrhosis:results of a patient population survey[J].Hepatology, 2006, 44 (6) :1535-1542.
    [2]Gine's P, Berl T, Bernardi M, et al.Hyponatremia in cirrhosis:from pathogenesis to treatment[J].Hepatology, 1998, 28 (3) :851-864.
    [3]Schrier RW.Water and sodium retention in edematousdisorders:role of vasopressin and aldosterone[J].Am JMed, 2006, 119 (Suppl 1) :S47-53.
    [4]Ishikawa SE, Schrier RW.Pathogenesis of hyponatremia:therole of arginine vasopressin in cirrhosis[M].Oxford:BlackwellScience, 2005:305-314.
    [5]Esteva-Font C, Baccaro ME, Fernández-Llama P, et al.Aquaporin-1 and aquaporin-2 urinary excretion in cirrhosis:relationship with ascites and hepatorenal syndrome[J].Hepatology, 2006, 44 (6) :1555-1563.
    [6]Gerbes AL, Gülberg V, Ginès P, et al.Therapy of hy-ponatremia in cirrhosis with a vasopressin receptorantagonist:a randomized double-blind multicenter trial[J].Gastroenterology, 2003, 124 (4) :933-939.
    [7]Berl T, Verbalis J.Pathophysiology of water metabolism.In:Brenner&Rector's The Kidney[M].Philadelphia:Elsevier, 2004, 857-920.
    [8]Halperin ML, Kamel KS.A new look at an old problem:therapy of chronic hyponatremia[J].Nat Clin Pract Nephrol, 2007, 3 (1) :2-3.
    [9]Restuccia T, Gómez-Ansón B, Guevara M, et al.Effects ofdilutional hyponatremia on brain organic osmolytes andwater content in patients with cirrhosis[J].Hepatology, 2004, 39 (6) :1613-1622.
    [10]Córdoba J, Gottstein J, Blei AT.Chronic hyponatremiaexacerbates ammonia-induced brain edema in rats after porto-caval anastomosis[J].J Hepatol, 1998, 29 (4) :589-594.
    [11]Murphy N, Auzinger G, Bernel W, et al.The effect ofhypertonic sodium chloride in intracranial pressure inpatients with acute liver failure[J].Hepatology, 2004, 39 (2) :464-470.
    [12]Abbasoglu O, Goldstein RM, Vodapally MS, et al.Livertransplantation in hyponatremic patients with emphasison central pontine myelinolysis[J].Clin Transplant, 1998, 12 (3) :263-269.
    [13]Londo?o MC, Guevara M, Rimola A, et al.Hyponatremiaimpairs early posttransplantation outcome in patientswith cirrhosis undergoing liver transplantation[J].Gastroenterology, 2006, 130 (4) :1135-1143.
    [14]Ruiz-del-Arbol L, Monescillo A, Jimenéz W, et al.Paracentesis-induced circulatory dysfunction:mechanismand effect on hepatic hemodynamics in cirrhosis[J].Gastroenterology, 1997, 113 (2) :579-586.
    [15]Wong F, Blei AT, Blendis LM, et al.A vasopressin receptorantagonist (VPA-985) improves serum sodium concentrationin patients with hyponatremia:a multicenter, randomized, placebo-controlled trial[J].Hepatology, 2003, 37 (1) :182-191.
    [16]Schrier RW, Gross P, Gheorghiade M, et al.Tolvaptan, aselective oral vasopressin V2-receptor antagonist, forhyponatremia[J].N Engl J Med, 2006, 355 (20) :2099-2112.
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  • 出版日期:  2011-03-20
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