腹水浓缩回输腹腔前后血清蛋白及RAAS系统激素水平变化研究

Serum Protein and RAAS System Hormone Level Changes before and after the Concentrated Ascites into Abdominal Cavity

目的:探讨腹水超滤浓缩回输对肝硬化顽固性腹水、肝癌腹水及其他腹腔恶性腹水患者的血浆白蛋白和RAAS系统激素水平的影响。方法:选取2014年3月-2016年2月本院符合标准的230例腹水患者为研究对象,将其随机分为两组。治疗组120患者进行腹水超滤浓缩回输治疗,对照组110患者进行常规放腹水、补充白蛋白治疗。检测治疗前后两组患者的腹水症状、血浆白蛋白和RAAS水平并进行比较。结果:与治疗前比较,两组患者治疗后血清总蛋白及清蛋白水平均有所升高,治疗组升高更加明显,差异均有统计学意义(P<0.05)。治疗后患者RAAS系统激素水平均呈不同程度下降,其中治疗组肾素、血管紧张素Ⅱ及醛固酮水平较治疗前均下降(P<0.05),对照组仅血管紧张素Ⅱ及醛固酮较治疗前下降(P<0.05);治疗后两组患者的RAAS激素水平比较,差异均有统计学意义(P<0.05)。治疗后,治疗组患者体重下降、腹围减少、24 h尿量增加更加明显,总有效率为83.33%,与对照组比较差异均有统计学意义(P<0.05)。结论:腹水超滤浓缩回输治疗肝硬化顽固性腹水、肝癌腹水及其他腹腔恶性腹水效果较好,可能与其升高白蛋白和降低RAAS系统激素水平作用有关。

Objective：To study the serum albumin and the RAAS system hormone levels in patients with ascites of cirrhosis,liver ascites or other abdominal malignant ascites and received autologous ultrafiltration concentrated ascites transfusion.Method：The 230 patients with ascites conformed the standard from March 2014 to February 2016 were randomly divided into the treatment group and the control group.The treatment group of 120 patients with ascites ultrafiltration concentration feedback treatment,the control group of 110 patients were given regular ascites,albumin supplementation therapy.The symptoms,the plasma albumin and RAAS system hormone level of the patients were detected respectively before and after treatment,and the results between two groups were compared.Result：Compared with before treatment,the serum total protein and albumin level of patients in two groups were increased after treatment,but the treatment group more apparently elevated（P〈0.05）.The RAAS system hormone levels in different degree of decline after treatment in two groups.The renin,angiotensinⅡ and aldosterone level of the treatment group were more significantly decreased than before treatment（P〈0.05）,but the control group only angiotensin and aldosteroneⅡ were significantly difference with before treatment（P〈0.05）. RAAS hormone levels after treatment in patients were significantly different between two groups （P〈0.05）.After treatment,patients manifested more obviously weight loss,bust reduced and 24 h urine volume increased of the treatment group,and the efficient rate of was 83.33%,the differences compared with the control group were statistically significant（P〈0.05）.Conclusion：The ultrafiltration concentrated ascites autologous transfusion treat for patients with intractable ascites of cirrhosis,liver ascites and other abdominal malignant ascites have excellent efficacy,and may related with its function of increasing albumin and reduce of the RAAS system hormone levels.