低钠血症对失代偿期肝硬化患者肝功能分级及预后的影响

目的探讨低钠血症与失代偿期肝硬化患者肝功能分级及预后的关系。方法回顾性分析162例失代偿期肝硬化伴低钠血症患者,根据其入院时血钠水平分为低钠血症轻、中、重度组,比较3组Child-pugh分级、主要并发症发生率及病死率。结果轻、中、重度组患者Child-pugh评分分别为6.86±1.45、7.98±1.69、9.96±2.23,低钠血症程度越严重,分值越高(P<0.01);主要并发症肝性脑病、肝肾综合征、低钾血症与顽固性腹水发生率随低钠血症的加重而升高,3组比较差异均有统计学意义(P<0.01或P<0.05);轻、中、重度组病死率分别为3.92%、19.72%、60.00%,3组比较差异均有统计学意义(P<0.05)。结论低钠血症在一定程度上反映失代偿期肝硬化患者肝功能受损状况,检测血钠水平可作为判断患者病情严重程度的重要指标。

Effect of hyponatremia on liver function grade and prognosis of decompensated cirrhosis cases

Objective To explore the relationship between hyponatremia and liver function grade and prognosis of decompensated cirrhosis cases.Methods One hundred and sixty-two decompensated cirrhosis cases with hyponatremia were analyzed retrospectively,according to their serum sodium levels,the patients were divided into mild,moderate and severe hyponatremia groups,and the Child-pugh grade,the incidence were compared among the main complications and case fatality rate of these three groups.Results Child-pugh grades of the mild group,the moderate group and the severe group were 6.86±1.45,7.98±1.69 and 9.96±2.23 respectively,the more serious of the degree of hyponatremia was,the higher the score was(P<0.01);the main complications,hepatic encephalopathy,hepatorenal syndrome,hypopotassaemia and the incidence of refractory ascites,increased with the worse of hyponatremia.The differences were statistical significant among the three groups(P<0.01 or P<0.05);case fatality rates of the mild group,the moderate group and the severe group were 3.92%,19.72% and 60.00% respectively,case fatality rates had significant differences among the three groups(P<0.05).Conclusion To some degree,hyponatremia reflected the damaged condition of liver function of decompensated cirrhosis cases.The serum sodium level in decompensated cirrhosis cases can be used as an important indicator to detect the disease severity.