肝硬化失代偿期患者低钠血症与肝性脑病及肾功能的相关性

Relationship between hyponatremia and hepatic encephalopathy and renal function in patients with decompensated cirrhosis

目的:探讨失代偿期肝硬化患者血钠水平与病情和肝性脑病、肝肾综合征的关系.方法:将我院收治120例失代偿期肝硬化按照血钠水平分为轻度、中度和重度低钠血症组;对3组患者进行Child-Pugh、MELD评分,并统计分析低钠血症与肝肾综合征、肝性脑病的相关性.结果:与轻度低钠血症组相比,中、重度组的Child-Pugh分级程度明显增加(U=4.303,6.317,P<0.05);其中重度组Child-Pugh分级程度显著高于中度组(U=2.816,P<0.05).轻度组肝性脑病和肝肾综合征的发病率显著低于中度组和重度组(2=17.912,76.305,6.058,37.502,P<0.05);而重度组肝性脑病和肝肾综合征发病率显著高于中度组(2=26.531,21.694,P<0.05).失代偿期肝硬化患者血钠水平与肝性脑病和肝肾综合征发生率密切相关.结论:低钠血症与失代偿期肝硬化患者并发症和预后有关,血钠水平可以作为患者病情和并发症的判断指标之一.

AIM： To explore the relationship between hypo- natremia and hepatic encephalopathy and liver and kidney syndrome in patients with decom- pensated cirrhosis. METHODS： One hundred and twenty patients with decompensated cirrhosis treated at our hos- pital were divided into three groups based on the level of serum sodium： mild, moderate and severe hyponatremia groups. Child-Pugh class and MELD score were calculated in all patients. The association of hyponatremia with hepatore- nal syndrome and hepatic encephalopathy was analyzed. RESULTS： Compared to the mild hyponatre- mia group, Child-Pugh class and MELD score increased significantly in the moderate and se- vere groups （U -4.303, 6.317, both P 〈 0.05）; and the increase was more significant in the severe group （U = 2.816, both P 〈 0.05）. The incidences of hepatic encephalopathy and hepatorenal syndrome were significantly lower in the mild group than in the moderate group and the se- vere group （2 = 17.912, 76.305, 6.058, 37.502, all P 〈 0.05）, as well as in the moderate group than in the severe group （a = 26.531, 21.694, both P 〈 0.05）. CONCLUSION： The levels of serum sodium are closely related to the occurrence of hepatic en- cephalopathy and renal function in patients with decompensated cirrhosis. Blood sodium level can be used as a parameter for evaluation of the patient＇s condition and complications.