评估低钠血症和MELD评分对肝硬化病人预后的价值

The prognostic value of hyponatremia and MELD score in the patients with liver cirrhosis

目的 评估低钠血症和MELD评分对肝硬化病人生存预测的价值。方法 对我院2002年至2005年收治的62例肝硬化病人的生存率进行回顾性评估，统计每例住院期间血清钠的水平，计算MELD评分及Child-Pugh评分，分析低钠血症和MELD评分与终末期肝硬化病人生存期的相关性。结果 随访62例中，年龄27-85岁，3个月内死亡共13例，死亡组血清钠（121．5±7．14）mmol／L，与生存组血清钠（135．6±7．47）mmol／L比较有非常显著差异（P〈0．001），计算低钠组死亡率为60．0％，血钠正常组死亡率为8．5％。结论 低钠血症可作为MELD评分的补充，二者都能确切反映病情危重程度，对肝硬化病人预后评估较Cllild-Push评分更有意义，值得临床应用。

Aim To evaluate the prognostic value of hyponatremia and MELD in the patients with liver cirrhosis. Method The survival rate of patients with liver cirrhosis from 2002 to 2005 in my hospital was retrospectively analyzed. Sera sodium level, MELD score and Child-Pugh score were documented. Relationship between hyponatremia, MELD and survival rate was analyzed. Result Among 62 patients （age from 27 to 83） followed up, 13 patients whose sera sodium level was （121.5 ± 7.14） mmol/L perished in 3 months, and other whose sera level was （135.6 ± 7.47） mmol/L survived more than 3 months. There was significantly difference of sera sodium level between 2 groups. The mortality of patients with hyponatremia was as high as 60.0%, while only 8.5% in normal sera sodium level groups. Conclusion Hyponatremia should be an complementation to the MELD scoring system, both of them which could reflect the severity of disease was better than Child-Pugh scoring system in evaluation the prognosis of patients with liver cirrhosis, and more application should be recommended in clinical practice.