Amra S, Elie R, Kronborg I
CMAJ. 1986 Sep 1;135(5):481-6.
We compared the charts of 33 patients who had refractory ascites with those of 33 patients who had responsive ascites to identify factors responsible for resistance to conventional therapy. The results of biochemical tests of liver function were more abnormal in the responsive group than in the refractory group on admission to hospital, whereas the results of kidney function tests were worse in the refractory group. The transhepatic portal pressure was similar in the 7 patients with refractory ascites and the 11 patients with responsive ascites in whom it was measured. The portal vein pressure as calculated from the difference in albumin content between the serum and the ascitic fluid was similar in the two groups, as were the findings at histologic examination of the liver. We conclude that neither the severity of the liver disease nor the portal pressure is a critical factor in the development of refractory ascites. Kidney dysfunction, however, is important, but its mechanism remains unclear.
我们比较了33例难治性腹水患者与33例反应性腹水患者的病历，以确定导致对传统治疗产生抵抗的因素。入院时，反应性腹水组的肝功能生化检查结果比难治性腹水组更异常，而难治性腹水组的肾功能检查结果更差。在测量经肝门静脉压力的7例难治性腹水患者和11例反应性腹水患者中，该压力相似。两组中根据血清与腹水白蛋白含量差异计算出的门静脉压力相似，肝脏组织学检查结果也相似。我们得出结论，肝病的严重程度和门静脉压力都不是难治性腹水发生的关键因素。然而，肾功能不全很重要，但其机制仍不清楚。
