肾素、血管紧张素Ⅱ及抗利尿激素与肝硬化腹水形成的关系

目的肾素-血管紧张素-醛固酮系统（RAAS）、抗利尿激素（ADH）与腹水的形成有着密切的关系，本研究旨在通过观察肝硬化患者血浆肾素活性（PRA）、血管紧张素Ⅱ（AngⅡ）以及ADH水平，探讨PRA、AngⅡ及ADH与肝硬化患者腹水形成的关系。方法选择47例肝硬化患者，其中Child—Pugh分级A级13例，B级19例，c级15例，肝硬化无腹水13例，腹水伴肝肾综合征（hepatorenal syndrome，HRS）8例，腹水无HRS26例，应用放射免疫方法分别检测其血浆PRA、AngⅡ及ADH表达水平进行检测，并以30例健康人为对照组进行比较。结果（肝功能）Child—PughB级及C级患者PRAAngⅡ及ADH水平均明显高于对照组与A级组，肝硬化患者在未合并腹水时PRA、AngⅡ及ADH水平与对照组比较无显著差异，在出现腹水后，与对照组比较差异有显著意义（P〈0．01）。腹水伴HRS组与腹水无HRS组比较，有显著差异（P〈0．05）。结论肝硬化患者血浆PRA、AngⅡ及ADH与肝硬化腹水的形成密切相关。

Correlation between hepatocirrhosis ascites and the level of plasma rennin angiotensin Ⅱ and antidiuretic hormone

Objective To explore the correlation between hepatocirrhosis ascites and the level of plasma rennin, angiotensin II, and antidiuretic hormone. Methods There were forty-seven hepatocirrhosis patients, including thirteen patients in Child-pugh A Group, nineteen patients in Child-pugh B Group, and fifteen patients in Child-pugh C Group. The level of serum PRA, Ang II and ADH were measured separately. Results The level of serum PRA, Ang II and ADH in Child-pugh B Group and C Group were higher significantly than those in Child-pugh A Group and control group. And there were no difference between the values of serum PRA, Ang II and ADH in hepatocirrhosis patients without ascites and those in the control group. But there were significantly difference between the values of serum PRA, Ang II and ADH in hepatocirrhosis patients with ascites and those in the control group (P<0.01). Additionally, there were significantly difference between the values of serum PRA, Ang II and ADH in hepatocirrhosis ascites patients with renal failure and those in hepatocirrhosis ascites patients without renal failure (P<0.05). Conclusion There were significantly positive correlations between the formation of hepatocirrhosis ascites and the level of plasma rennin, angiotensin II, and antidiuretic hormone.