严重肝病患者血氨的变化及其意义

The Clinical Changes and Significance of Blood Ammonia in Patients with Severe Liver Diseases

目的 :探讨严重肝病患者血氨变化及其意义。方法 :采用酶法测定 10 2例严重肝病患者 (重型肝炎 6 8例、失代偿肝硬化18例、原发性肝癌 16例 )和 5 6例一般慢性肝炎患者的血氨含量。结果 :慢性肝炎患者血氨正常 ,而严重肝病患者的血氨则显著增高。随着病情进展 ,严重肝病患者血氨浓度的增高与肝性脑病的严重程度呈明显正相关。结论 :血氨增高在肝性脑病发病机理中起着重要的作用。动态测定血氨对重型肝炎患者的诊断及治疗具有较为重要的临床意义。

Objective:To investigate the clinical changes and significance of blood ammonia in patients with sever liver diseases.Method:Blood Ammonia in 102 patients with severe liver diseases(68 with severe hepatitis,18 with decompensate cirrhosis and 16 with primary hepatic carcinoma) and 56 patiens with chronic hepatitis were determined by enzymatic method.Results:The contents of blood ammonia in chronic hepatitis were in the normal range but significantly high in patients with severe liver diseases.With the aggravation of severe hepatitis,the contents of blood ammonia tended to be obviously increased in patients with hepatic encephalopathy.Conclusions:High level of blood ammonia may play an important role in the hepatic encephalopathy.It has great clinical significance to detect blood ammonia dynamically for diagnoses and treatment of severe hepatitis patients.