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肝硬化患者的总体水、细胞外液、血浆容量及总体钾含量

Total body water, extracellular water, plasma volume, and total body potassium in cirrhosis of the liver.

作者信息

Schober O, Mariss P, Schmidt F W, Hundeshagen H

出版信息

Klin Wochenschr. 1979 Aug 1;57(15):757-61. doi: 10.1007/BF01478033.

Abstract

Extracellular water (EWC; 82-bromide), total body water (TBW; 3-THO), intracellular water (ICW = TBW-ECW), plasma volume (PV; 51-Cr), and total body potassium (TBK; 40-K) were studied in patients with cirrhosis of the liver (n = 12) and in controls (n = 12). ECW (39%), TBW (28%), ICW (19%), and PV (24%) increased, TBK (28%) however, decreased in cirrhosis. The results indicate that it is less the lean body mass, but rather the intracellular potassium concentration that is lowered (cirrhosis: 84 +/- 21 mmol/l ICW; controls: 115 +/- 23 mmol/l ICW). Decreased potassium per cell (mmol) and increased intracellular water are discussed as possible reasons for this. The correlation between TBK (%) and serum potassium (mmol/l) was found to be r = 0.56 (p less than 0.002). Correlations between the biochemical parameters gamma-globulins, cholin esterase, serum sodium and serum albumin (g/l PV) and characteristic fluid disturbances in cirrhosis are highly significant whereas albumin (g/kg bodyweight) was the same in both groups. We can support the 'overflow theory' of ascites formation.

摘要

对12例肝硬化患者和12例对照者进行了细胞外液(EWC;82-溴化物)、总体水(TBW;3-THO)、细胞内液(ICW = TBW - ECW)、血浆容量(PV;51-铬)和总体钾(TBK;40-钾)的研究。肝硬化患者的细胞外液(增加39%)、总体水(增加28%)、细胞内液(增加19%)和血浆容量(增加24%)均增加,然而总体钾却减少了28%。结果表明,降低的并非瘦体重,而是细胞内钾浓度(肝硬化:细胞内液为84±21 mmol/L;对照者:细胞内液为115±23 mmol/L)。细胞内钾含量(mmol)减少和细胞内液增加被认为是造成这种情况的可能原因。发现总体钾(%)与血清钾(mmol/L)之间的相关性为r = 0.56(p < 0.002)。肝硬化患者的生化参数γ-球蛋白、胆碱酯酶、血清钠和血清白蛋白(g/L血浆容量)与特征性液体紊乱之间的相关性非常显著,而两组的白蛋白(g/kg体重)相同。我们支持腹水形成的“溢流理论”。

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