限制钠饮食对肝硬化腹水患者腹水的影响。
Effect of a diet with unrestricted sodium on ascites in patients with hepatic cirrhosis.
机构信息
Department of Liver Disease, Wuxi Hospital for Infectious Diseases, Wuxi, China.
出版信息
Gut Liver. 2012 Jul;6(3):355-61. doi: 10.5009/gnl.2012.6.3.355. Epub 2012 Jul 12.
BACKGROUND/AIMS: There has been debate on whether a sodium-restricted diet (SRD) should be used in cirrhotic patients with ascites in China in recent years. The purpose of this study was to compare the effect of sodium-restricted and unrestricted diets on plasma renin activity (PRA), renal blood flow (RBF) and ascites in patients with liver cirrhosis.
METHODS
Two hundred cirrhotic patients with ascites were randomly divided into two groups (98 cases in the sodium-unrestricted diet [SUD] group and 102 cases in the SRD group); 95 patients (96.94%) in the SUD group and 97 patients (95.1%) in the SRD group had post-hepatitis B cirrhosis.
RESULTS
Blood sodium and RBF were higher in SUD group than in SRD group (p<0.001), while PRA were significantly lower in SUD group than the SRD group 10 days after treatment (p<0.001). Renal impairment caused by low blood sodium was higher in SRD group than in SUD group (p<0.01). Ascites disappeared in higher proportion of patients in SUD group than in SRD group (p<0.001).
CONCLUSIONS
SUD can increase the level of blood sodium and RBF, and be beneficial to diuresis and ascite reduction and disappearance.
背景/目的：近年来，中国对于肝硬化伴腹水患者是否应采用限钠饮食一直存在争议。本研究旨在比较限钠和不限钠饮食对肝硬化患者血浆肾素活性（PRA）、肾血流量（RBF）和腹水的影响。
方法
将 200 例肝硬化腹水患者随机分为两组（限钠饮食组[SUD]98 例，SRD 组 102 例）；SUD 组 95 例（96.94%），SRD 组 97 例（95.1%）为乙型肝炎后肝硬化。
结果
SUD 组血钠和 RBF 均高于 SRD 组（p<0.001），而治疗 10 天后 SUD 组 PRA 明显低于 SRD 组（p<0.001）。SRD 组因低血钠引起的肾功能损害高于 SUD 组（p<0.01）。SUD 组腹水消失的患者比例高于 SRD 组（p<0.001）。
结论
SUD 可增加血钠和 RBF 水平，有利于利尿和减少腹水。
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