He Yong, Li Gui-Xing, Xia Yong
Division of Clinical Biochemistry Assay, Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China.
Zhonghua Gan Zang Bing Za Zhi. 2010 Jan;18(1):45-8. doi: 10.3760/cma.j.issn.1007-3418.2010.01.011.
To analyze the relationship between hepatorenal syndrome (HRS) and plasma ammonia.
Plasma ammonia, liver and renal function of 465 patients with liver cirrhosis in our hospital, from June 2007 to March 2009, were analyzed. 80 renal dysfunction patients and 80 healthy controls were recruited in the control group. In addition, 40 patients with HRS were followed up.
Using urea as the diagnosis standard of HRS, the morbidity rate of HRS was 39.6%, which was higher than that using creatinine as the diagnosis standard of HRS (Chi-square test = 97.33, P less than 0.01). using urea and creatinine as the diagnosis standard of HRS, the ammonia level of HRS groups was (57.39+/-48.83)mumol/L, (64.80+/-47.25)mumol/L, which were higher than that in the non-HRS groups (t = -3.07, t = -3.67, P less than 0.01). The ammonia level of patients with renal dysfunction was (26.59+/-14.34)mumol/L, which was lower than that in HRS group, non-HRS group (P less than 0.01), but there was no statistical significance between the patients with renal dysfunction and the healthy peoples [(22.36+/-8.72)mumol/L] (t = 1.52, P more than 0.05). The followed-up analysis of 40 patients with HRS indicated that plasma ammonia level was positively correlated with urea and creatinine, and correlation coefficients were 0.874 and 0.834 (P less than 0.05).
Hepatic encephalopathy is liver-kidney-intestine-brain syndrome. HRS plays an important role in the development of hepatic encephalopathy.
分析肝肾综合征(HRS)与血浆氨之间的关系。
对我院2007年6月至2009年3月收治的465例肝硬化患者的血浆氨、肝功能及肾功能进行分析。对照组纳入80例肾功能不全患者及80例健康对照者。此外,对40例肝肾综合征患者进行随访。
以尿素作为肝肾综合征的诊断标准,肝肾综合征发病率为39.6%,高于以肌酐作为肝肾综合征诊断标准时的发病率(卡方检验=97.33,P<0.01)。以尿素和肌酐作为肝肾综合征的诊断标准时,肝肾综合征组的氨水平分别为(57.39±48.83)μmol/L、(64.80±47.25)μmol/L,高于非肝肾综合征组(t=-3.07,t=-3.67,P<0.01)。肾功能不全患者的氨水平为(26.59±14.34)μmol/L,低于肝肾综合征组及非肝肾综合征组(P<0.01),但肾功能不全患者与健康人群[(22.36±8.72)μmol/L]之间无统计学差异(t=1.52,P>0.05)。对40例肝肾综合征患者的随访分析表明,血浆氨水平与尿素及肌酐呈正相关,相关系数分别为0.874和0.834(P<0.05)。
肝性脑病是肝-肾-肠-脑综合征。肝肾综合征在肝性脑病的发生发展中起重要作用。