全身炎症反应与肝肾综合征关系的研究

目的分析肝衰竭患者并发肝肾综合征(HRS)与全身炎症反应(SIRS)的关系。方法在137例肝衰竭患者中,合并HRS68例,单纯肝衰竭69例。收集两组患者Child-Pugh分级、终末期肝病模型(MELD)和SIRS评分。结果 HRS患者SIRS评分为0.70±0.86分,高于对照组0.36±0.54分(P<0.05),白细胞计数为8.96±4.45×109/L,显著高于对照组(5.79±2.40×109/L,P<0.05);HRS患者总胆红素和凝血酶原时间分别为404.5μmol/L和21.7±8.8s,高于对照组(259.0μmol/L和17.6±9.6s,P<0.05),而钠和氯分别为132.6±6.0mmol/L和92.2±9.1mmol/L,显著低于对照组(137.2±3.8mmol/L和99.5±9.3mmol/L,P<0.05)。结论 SIRS与肝衰竭患者并发HRS关系密切。

Relationship between systemic inflammation response syndrome and hepatorenal syndrome in patients with liver failure

Objective To study the relationship between systemic inflammation response syndrome （SIRS） and hepatorenal syndrome （HRS） by analyzing clinical data,SIRS score and laboratory parameters in patients with liver failure. Methods 137 patients with liver failure in our hospital were enrolled,and 68 of them had HRS and 69 without. The SIRS score,Child-Pugh class and model for end-stage liver disease （MELD）were obtained. Results SIRS score in patients with HRS was 0.70±0.86,much higher than 0.36±0.54（P〈0.05）in patients without; leukocyte counts in patients with HRS were 8.96±4.45×10^9/L,whicb was higher than that （5.79±2.40×10^9/L）in patients without HRS （P〈0.05）;total hilirubin,protbrombin time in patients with HRS were 404.5μmol/L and 21.7±8. 8s respectively,much higher than 259.01μmol/L and 17.6±9.6s（P〈0.05）in patients without,however,sodium,chloride were 132.6±6.0mol/L and 92.2±9.1mmol/L,mueh lower than 137.2±3.8mmol/L and 99.5±9.3mmol/L （P〈0.05）in patients without. Conclusion Systemic inflammatory response syndrome is associated with the development of HRS in patients with liver failure.