中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

肝硬化并发肾上腺皮质功能不全患者的临床特点分析

叶颖剑 胡乃中

引用本文:
Citation:

肝硬化并发肾上腺皮质功能不全患者的临床特点分析

详细信息
  • 中图分类号: R575.2

Clinical analysis of cases of liver cirrhosis complicated with adrenal insufficiency

  • 摘要: 目的了解肝硬化患者的血清基础皮质醇及促肾上腺皮质激素(ACTH)水平,探讨肝硬化患者并发肾上腺皮质功能不全(AI)的临床意义及特点。方法 118例肝硬化患者用化学发光方法测量血清基础皮质醇及ACTH水平,然后将其分为并发AI组和未并发AI组,前瞻性地分析两组患者的临床特点及预后。同期选取30名胃肠息肉患者为对照组。结果本组肝硬化患者基础皮质醇水平为(329.67±136.1)nmol/L,显著低于对照组的(460.7±165.48)nmol/L(t=-4.501,P<0.05)。肝硬化中并发AI者32例占27.1%(32/118),AI组与未并发AI的肝硬化患者比较,在并发自发性腹膜炎(SBP)、Child分级、Child评分、MELD评分及病死率方面明显增高,两组差异有统计学意义(P<0.05);32例并发AI的肝硬化患者白蛋白、高密度脂蛋白-胆固醇(HDL-C)水平明显减低,出现面部色素沉着及腹水的发生率较高(P<0.05),然而其他临床特点及实验室指标,两组差异无统计学意义。结论肝硬化患者基础皮质醇水平明显减低,并发AI的患者SBP的发生率高、肝损伤的严重、病死...

     

  • [1]Marik PE, Gayowski T, Starzl TE.The hepatoadrenal syn-drome:a common yet unrecognized clinical condition[J].Crit Care Med, 2005, 33 (6) :1254-1259.
    [2]Fede G, Spadaro L, Tomaselli T, et al.Assessment of adre-nocortical reserve in stable patients with cirrhosis[J].J Hep-atol, 2011, 54 (2) :243-250.
    [3]O'Beirne J, Holmes M, Agarwal B, et al.Adrenal insuffi-ciency in liver disease–what is the evidence[J].J Hepa-tol, 2007, 47 (3) :418-423.
    [4]Aravinthan A, Al-Naeeb Y, Richardson P, et al.Relativeadrenal insufficiency in a patient with liver disease[J].Eur JGastroenterol Hepatol, 2009, 21 (4) :471-473.
    [5]Galbois A, Rudler M, Massard J, et al.Assessment of adre-nal function in cirrhotic patients:salivary cortisol should bepreferred[J].J Hepatol, 2010, 52 (6) :839-845.
    [6]中华医学会肝病学分会, 中华医学会感染病学分会.慢性乙型肝炎防治指南[J], 中华肝脏病杂志, 2005, 13 (z1) :881-891.
    [7]McCann VJ, Fulton TT.Cortisol metabolism in chronic liver dis-ease[J].J Clin Endocrinol Metab, 1975, 40 (6) :1038-1044.
    [8]Tsai MH, Peng YS, Chen YC, et al.Adrenal insufficiency inpatients with cirrhosis, severe sepsis and septic shock[J].Hepatology, 2006, 43 (4) :673-681.
    [9]Wiest R, Moleda L, Zietz B, et al.Uncoupling of sympathet-ic nervous system and hypothalamic-pituitary-adrenal axisin cirrhosis[J].J Gastroenterol Hepatol, 2008, 23 (12) :1901-1908.
    [10]Arabi YM, Aljumah A, Dabbagh O, et al.Low-dose hydro-cortisone in patients with cirrhosis and septic shock:a random-ized controlled trial[J].CMAJ, 2010, 182 (18) :1971-1977.
    [11]忠弼.病理学[M].北京:人民卫生出版社, 2006:405-419.
    [12]Yaguchi H, Tsutsumi K, Shimono K, et al.Involvement ofhigh density lipoprotein as substrate cholesterol for steroido-genesis by bovine adrenal fasciculo-reticularis cells[J].Life Sci, 1998, 62 (16) :1387-1395.
    [13]de la Llera-Moya M, Connelly MA, Drazul D, et al.Scav-enger receptor class B type 1 affects cholesterol homeostasisby magnifying cholesterol flux between cells and HDL[J].JLipid Res, 2001, 42 (12) :1969-1978.
    [14]Thabut D, Tazi KA, Bonnefont-Rousselot D, et al.High dc-nsity lipoprotein administratjon attcnuates liver prolnflamma-tory response, restores liver endotheIial nitric oxide synthaseactivlty, and lowers portal pressure in cirrhotic rats[J].Hepa-tology, 2007, 46 (6) :1893-1906.
  • 加载中
计量
  • 文章访问数:  3031
  • HTML全文浏览量:  19
  • PDF下载量:  685
  • 被引次数: 0
出版历程
  • 出版日期:  2012-05-20
  • 分享
  • 用微信扫码二维码

    分享至好友和朋友圈

目录

    /

    返回文章
    返回