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目的探讨低钠血症在肝硬化腹水患者中的发生率以及对预后的影响。方法随机选取2007—2009年间住院的196例肝硬化腹水患者,测定血钠水平,以血钠大于135mmol/L小于155mmol/L为正常血钠组,血钠大于130mmol/L小于135mmol/L为轻度低钠组,血钠小于130mmol/L为中重度低钠组;同时进行Child-Pugh肝功能分级,并分析与肝硬化的并发症和预后的关系。结果在肝硬化腹水的患者中低钠血症发病率为47.4%,其中轻度低钠血症26.5%,中重度低钠血症20.9%;低钠组与正常血钠组比较在肝功能Child-Pugh分级、死亡率、及并发肝性脑病、肝肾综合征等方面差异均有统计学意义(P<0.01),轻度低钠组在死亡率上显著低于中重度低钠组(P<0.01)。结论肝硬化腹水患者易并发低钠血症,且死亡率增加。低血钠的程度与肝功能Child-Pugh分级以及并发肝性脑病、肝肾综合征等的发生率有很大关系。
Objective To investigate the incidence of hyponatremia in cirrhotic patients and prognosis. Methods A total of 196 cirrhotic patients with ascites were enrolled in this study. Serum sodium levels were measured with serum sodium greater than 135mmol / L and less than 155mmol / L as normal serum sodium group, serum sodium greater than 130mmol / L and less than 135mmol / L as light Degree of low sodium group, serum sodium is less than 130mmol / L for moderate to severe hypothyroidism group; at the same time, Child-Pugh liver function grading, and analysis and complications of liver cirrhosis and prognosis. Results The incidence of hyponatremia was 47.4% in patients with cirrhosis and ascites, 26.5% in mild hyponatremia and 20.9% in moderate and severe hyponatremia. Compared with normal sodium group, -Pugh classification, mortality, and concurrent hepatic encephalopathy, hepatorenal syndrome and other aspects were statistically significant (P <0.01), mild low sodium group mortality was significantly lower than moderate and severe low sodium group (P <0.01). Conclusions Patients with cirrhosis and ascites are prone to hyponatremia and the mortality rate increases. The degree of hyponatremia is closely related to the Child-Pugh classification of liver function and the incidence of concurrent hepatic encephalopathy and hepatorenal syndrome.