肝硬化患者电解质紊乱的临床分析

Electrolytes disorder in patients with cirrhosis

关键词:  肝硬化  Child-pugh分级  电解质  低钠血症  预后

Key words:  cirrhosis  Child-Pugh degree  electrolyte  hyponatremia  prognosis

摘要:

目的探讨肝硬化患者电解质紊乱情况及其与肝功能Child-pugh分级的关系。方法对162例肝硬化患者肝功能Child-pugh分级、电解质情况及病情预后进行回顾性分析。结果肝硬化患者电解质紊乱以低Na⁺最为常见,Na⁺、K⁺、C1^-3种离子均数与肝功能Child-pugh分级有关,尤其是Na⁺和K⁺。低Na⁺、低K⁺、低C1^-发生率随A、B、C分级程度的提高而呈上升趋势(P<0.01)。血Na⁺水平越低,低K⁺、肝性脑病、顽固性腹水、死亡的发生率越高,而肝功能Child-pugh分级中的总胆红素、腹腔积液、白蛋白与血Na⁺水平具有相关性.结论肝硬化患者电解质紊乱以低Na⁺最为常见,血Na⁺水平可作为判断肝硬化病情严重程度及预后的重要参考指标。

Abstract:

Objective To investigate the relationship between Child-Pugh degree of cirrhosis and electrolytes disorder. Methods The Child-Pugh degree, electrolytes and prognosis were analyzed retrospectively in 162 patients with cirrhosis. Results Low Na⁺ was mostly common in electrolytes disorder. The mean values of 3 electrolytes were associated with Child-Pugh degree, especially Na⁺ and K⁺ The rate of electrolytes disorder was positively correlated with Child-Pugh degree. The Na⁺ levels were negatively correlated with the incidence rate of low K⁺ ,hepatic encephalopathy, refractory ascites and death. Multiple regression analysis revealed that the level of Na⁺ was correlated with total bilirubin, ascites and albumin. Conclusion Low Na⁺ is mostly common in electrolytes disorder of patients with liver cirrhosis and might be a reliable prognostic marker.