肝硬化腹水机理研究——血液动力学、体液、神经等多因素分析

Rend hemodynamics, RAAS, SAS and ANP incirrhosis: Relationship to sodium retention

本文对肾素血管紧张素—醛固酮系统（RAAS）、交感—肾上腺系统（SAS）及心钠素（ANP）的测定认为：肝硬化腹水时有明显的肾脏钠潴留，晚期可有肾血流量（RBF）和肾小球滤过率（CFR）下降；肝硬化时RAAS和SAS活动增强，尤其是后者，与晚期肝硬化腹水的肾功能异常密切相关；肝硬化时血浆ANP的水平升高，有腹水者ANP升高尤为显著。

The renal hemodynamics and renin 梐ngiotensin -aldosterone system (RAAS) and sympathetic ?a-drenal system (SAS) and-atrial natriuretic peptide (ANP) in relation with sodium retention were studied in 44 patients with liver cirrhosis (24 cases with and 20 cases without ascites) and 35 cases of normal control, our multivariate analysis of the fac ?tors playing a role in sodium retention showed that plasma nora-drenaline concentration and creatinine clearance rate were the only two important factors' acting independent-ly. It was concluded that in patients with cirrhosis and asci-tes, significant sodium retention was present, and the renal blood flow and glomerular filtration rate were dec梤eased, and the activities of RAASand SAS were enhanced, especially the latter, and they were closely correlated with the renal hemodynamic disorder and sodium retention, plasma ANF level was also elevated in patients with cirrhosis and it was more significant in patients with ascites .