肝硬化患者SAS.RAAS与肾功能异常

本研究发现肝硬化腹水患者有效肾血浆流量及内生肌酐清除率显著降低,有明显的钠潴留;肝硬化时SAS及RAAS活动增强是肾脏钠潴留的重要因素.交感神经活动增强亦是肝硬化腹水患者肾血流动力学异常的重要原因之一

SAS AND RAAS IN CIRRHOSIS: RELATIONSHIP TO RENAL FUNCTIONAL ABNORMALITIES

The Sympathetic-adrenal system (SAS) and renin-angiotensin-aldosterone system (RAAS) in relation with the abnormalit-ies of renal function were studied in a total of 44 patients with liver cirrhosis and 35 cases of normal control. Our results showed that in patients with cirrhosis and ascites, a significant sodium retention was present, the renal blood flow and glomerular filtration rate were decreased; the plasma renin activity and the plasma concentrations of angiotensin II, aldosterone, nb-radrenaline, adrenaline and 24 hours urinary excretion of noradrenaline and adrenaline were all significantly increased, and they were negatively correlated with 24 hours urinary sodium excretion; a negative relationship also existed between plasma noradrenaline concentration and effctive renal plasma flow. It was concluded that the enhanced activities of RAAS and SAS were the important factors for renal sodium retention, and the latter was also playing an important role in the abnormality of renal hemo dynamics in patients with cirrhosis and ascites