肝硬化腹水与血钠关系研究

Study on the relationship between liver cirrhosis ascites and plasma sodium

目的比较补钠与限钠对肝硬化腹水消退和预后的影响，研究肝硬化腹水与血钠关系。方法119例肝硬化患者随机分为补钠组60例、限钠组59例。补钠组低盐饮食，静脉补氯化钠（3—5）g／d；限钠组低盐饮食。治疗前、后6d和12d检测血和尿中钠、氯，观察尿量、腹水消退和临床转归情况。结果补钠组治疗后12d血钠（139．06±7．01）mmol／L、血氯（105．76±5．46）mmol／L与同组治疗前和治疗后6d比较（P〈0．05），与限钠组治疗后12d比较（P〈0．01），尿钠（269．04±61．23）mmol／L、尿氯（249．21±38．98）mmol／L、尿量（2445．83±609．09）ml／d，与同组治疗前和治疗后6d比较（P〈0．01）；与限钠组治疗后12d比较（P〈0．05），补钠组腹水消退时间、肝性脑病、肝肾综合征的发生率、病死率均低于限钠组。结论肝硬化腹水适当补钠有利于腹水消退，可以改善患者的预后。

Objective To compare sodium supplement and sodium restriction to the effect of the extinction and prognosis of liver cirrhosis ascites, and research the relationship between live cirrhosis ascites and plasma sodium. Methods 119 liver cirrhosis patients were randomly divided into 2 groups ：60 cases of sodium supplement and 59 cases of sodium restriction. 60 cases of sodium supplement was kept low-salt diet and intravenous sodium chloride supplement （3- 5 g/d） ,59 cases of sodium restriction was only kept low-salt dict. Plasma sodium, plasma chloride, urine sodium,urine sodium chloride were detected before treatment, and 6 days, 10 days after treatment respectively. And the urine quantity,extinction of ascites and prognosis were compared. Results There were significant differences on the increase of plasma sodium, plasma chloride, urine sodium, urine chloride and urine quantity after treatment in two groups. Extinction time of ascites was shorter in group of sodium supplement. The morbidity and fatality rate of hepatic enccphalopathy, and hepatorenal syndrome in the group of sodium supplement were lower than that in the group of sodium restriction. Conclusion Sodium supplement should be adapted when using diuretic agent to help the extinction of ascites, and to improve recovery.