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肝肾综合征的防治 被引量：1

Prevention and treatment of hepatorenal syndrome
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摘要 一、定义 肝肾综合征(hepatorenal syndrome,HRS)的定义和诊断标准以国际腹水协作组1996年的共识为准[1]:HRS是合并门脉高压慢性肝病的肝衰晚期的功能性肾损害,急性肝衰也出现HRS.诊断的基本标准是血清肌酐＞1.5mg/dl(1 32.6μmol/L)、肌酐清除率＜40ml/min、尿蛋白＜500mg/日且无超声学的阻塞性肾病或肾实质疾病、停用利尿剂和扩张血容量(1.5 L等渗盐水)后肾功能无改善;其它标准为:尿量＜500ml/日、尿钠＜10mmol/L、尿肾渗透压高于血浆,尿红细胞每高倍视野＜50个、血清钠＜130mmol/L.必需排除休克、感染、肾毒性药物或低血容量.
作者 聂玉强 李瑜元
机构地区 广州市第一人民医院消化内科
出处 《现代消化及介入诊疗》 2003年第1期6-9,共4页 Modern Interventional Diagnosis and Treatment in Gastroenterology
关键词 肝肾综合征 诊断标准 肝功能 发病机制 循环障碍 原发性细菌性腹膜炎 黄疸
分类号 R575 [医药卫生—消化系统] R692 [医药卫生—泌尿科学]
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参考文献28

  • 1[1]Arroyo V, Gines P, Gerbes AL, et al. Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis. Hepatology 1996; 23: 164-176.
  • 2[2]Chutaputti A. Management of refractory ascites and hepatorenal syndrome. J Gastroenterol Hepatol 2002; 17: 456-461.
  • 3[3]Garcia-Tsao G. Current management of the complications of cirrhosis and portal hypertension: variceal hemorrhage, ascites, and spontaneous bacterial peritonitis. Gastroentero- logy 2001; 120:726-748.
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同被引文献16

  • 1张晶,段钟平.肝肾综合征的治疗现状[J].国外医学（移植与血液净化分册）,2004,2(6):1-3. 被引量：3
  • 2张玉果,赵彩彦.肝肾综合征的研究进展[J].河北医药,2005,27(1):13-14. 被引量：3
  • 3Arroyo V, Gines P. Gerbes AL, et al. Defllaition and diagnostic criteria of refractory ascites and hepatorenal syndrome in clrrhosis[J]. Hepatology 1996,23(1) :164-176.
  • 4Chutaputti A. Mangement of refractory aseites and hepatorenal syndrome[J]. J Gastroenterol H epatol. 2002,17 (2) :456-461.
  • 5朱舜时.肾脏并发症[A]．姚光弼．临床肝脏病学[M]．第1版．上海：上海科学技术出版社，2004．296-303．
  • 6Schrier RW, Arroyo V, Bemardi M, et al. Peripheral arterial vasodilation hypothesls: a proposal for the initiation of renal sodium and water retention in cirrosis[J]. Hepatology, 1988,8(5) :1151-1157.
  • 7Guevara M. Bru C, Giues P, et al. Increased cerebrovascular resistance in cirrhotic patients with ascltes[ J ]. Hepatology, 1998,28 ( 1 ) : 39-44.
  • 8Hall JE,Brands MW. The renin-angiototensln system: renal mechansujnns and c irculatory homestasis[A]. Seldin DW, Giebsch G(eds) :The kidney Physioloy and path ophysiology[M]. New York:Raven Press, 1992. 1455-1504.
  • 9Henriksen JH, Ring-Larsen H. Hepatorenal disorders:role of the symparhd tic nervous system[J]. Sere Liver Dis, 1994,14( 1 ) :35-43.
  • 10Anand A, Harry D, Holt S, et al. Endothilin is an important determinant of renal function in a rat model of active livet tenal failure[J]. Gur, 2002,50(1):111-117.

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现代消化及介入诊疗
2003年 第1期

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