肝硬化肝肾综合征患者肾功能与血氨水平的临床相关性研究

Relationship between kidney function and blood ammonia levels in cirrhosis patients with hepatorenal syndrome

目的探讨肝硬化肝肾综合征患者肾功能与血氨水平的相关性。方法选取梧州市红十字会医院2010年2月-2014年2月收治的肝硬化患者100例,根据病情发展的差异将患者分为试验组和对照组,其中试验组36例,出现肝肾综合征;对照组64例,未出现肝肾综合征。比较两组患者肾脏相关生化指标与血氨水平,研究二者之间的相关性。结果试验组总胆红素、直接胆红素、天冬氨酸氨基转移酶、丙氨酸氨基转移酶、尿素氮、肌酐的水平明显高于对照组;而总蛋白、氯离子的水平明显低于对照组,差异有统计学意义(P<0.05)。试验组尿素氮、肌酐与血氨呈正相关。结论肝硬化肝肾综合征患者肾功能与血氨水平存在相关性,血氨水平升高直接增加肝肾综合征的发生率。

Objective To investigate the clinical relevance of kidney function and blood ammonia levels in cirrhosis patients with hepatorenal syndrome. Methods One hundred cases of liver cirrhosis patients treated in Wuzhou Red Cross Hospital from Feb. 2010 to Feb. 2014 were selected, patients were divided into test group and control group based on differences in disease progression, 36 patients in test group appeared hepatorenal syndrome; 64 cases in the control group did not appear hepatorenal syndrome. The correlation between kidney-related biochemical indicates and blood am- monia levels were analyzed. Results TB, DB, AST, ALT, BUN, CREA levels were significantly higher in test group than those in control group; and TP, C1 levels were significantly lower in test group than those in control group, the difference was statistically significant （P 〈 0.05）. BUN and CREA were related to blood ammonia levels in test group. Conclusion Kidney function is related with blood ammonia levels in cirrhosis patients with hepatorenal syndrome, ele- vated blood ammonia levels directly increase the incidence of hepatorenal syndrome.