胱抑素和血钠及血氨在早期判断慢加急性肝衰竭并发肝肾综合征中的价值

The value of cystatin,blood sodium and blood ammonia in early diagnosis of acute liver failure complicated with hepatorenal syndrome

目的:探讨胱抑素(Cys-C)、血钠、血氨在早期判断慢加急性肝衰竭并发肝肾综合征(HRS)中的价值。方法:选择2018年5月—2019年5月就诊的慢加急性肝功能衰竭患者60例,将其按是否并发HRS分为慢加急性肝衰竭并发HRS组(HRS组)和慢加急性肝衰竭未并发HRS组(非HRS组),收集各组病例肝功能、肾功能(Cys-C)、凝血功能、血氨、电解质等数据,分析各组差异以及Cys-C,Na,NH^3+与HRS的关系。结果:HRS组Cys-C,Na,NH^3+水平明显较非HRS组高(P<0.05);HRS组总胆红素(TBIL)、白蛋白(ALB)、国际标准化比值(INR)水平明显较非HRS组高(P<0.05);Cys-C,Na,NH^3+三个指标之间,两两均成正相关关系(P<0.05)。结论:Cys-C、血钠、血氨水平与慢加急性肝衰竭患者是否并发肝肾综合征密切相关,在早期判断慢加急性肝衰竭并发肝肾综合征中具有一定临床价值。

Objective:To investigate the value of cystatin(Cys-C),serum sodium and serum ammonia in early diagnosis of chronic acute liver failure complicated with hepatorenal syndrome.Methods:Sixty patients with chronic acute liver failure who were treated from May 2018 to May 2019 were selected.According to the diagnosis basis of hepatorenal syndrome,it was divided into chronic acute liver failure complicated with HRS group(HRS group)and slow acute liver failure without HRS group(non-HRS group).The data of liver function,renal function(Cys-C),coagulation function,blood ammonia,electrolytes were collected from each group.The differences between groups and the relationship between Cys-C,Na,NH^3+ and HRS were analyzed.Results:There was no significant difference in gender and age between the two groups(P>0.05).The mean age of the HRS group was significantly higher than that of the non-hrs group(P<0.05).The levels of Cys-C,Na and NH^3+ in HRS group were significantly higher than those in non-hrs group(P<0.05).Total bilirubin(TBIL),albumin(ALB)and international normalized ratio(INR)levels were significantly higher in the HRS group than in the non-hrs group(P<0.05).There was a positive correlation between Cys-C,Na and NH^3+(P<0.05).Conclusion:The levels of Cys-C,serum sodium and serum ammonia are closely related to the complications of liver-kidney syndrome in patients with chronic acute liver failure,and have certain clinical value in early judgment of the complications of chronic acute liver failure with liver-kidney syndrome.