肝硬化腹水患者腹内压与醛固酮相关性分析

发布时间：2018-03-10 20:12

本文选题：肝硬化　切入点：醛固酮　出处：《南昌大学》2014年硕士论文　论文类型：学位论文

【摘要】：研究背景和目的：我国是一个乙肝高发的国家，肝硬化腹水是晚期肝硬化患者最难以忍受的症状之一，因而腹水的有效的治疗对于晚期肝硬化患者是一种提高生存质量的重要方法。肝硬化腹水特别是难治性腹水在临床上仍是一个治疗难题，虽然目前有多种药物及方法运用于肝硬化难治性腹水的治疗，但效果仍不容乐观。本研究旨在探讨肝硬化腹水患者腹内压与年龄、血清白蛋白、血清钠、PT、血浆醛固酮、腹围呼吸差值的关系，得出腹内压与RAAS系统的相关性为肝硬化患者腹水的治疗特别是难治性腹水的治疗提供理论依据。研究方法：通过对56例我院确诊的肝硬化腹水患者在抽腹水前用一次性玻璃测压管测腹内压并同时行血清白蛋白、血清钠、PT、腹围呼吸差值、血浆醛固酮检查，同时对30例我院确诊的肝硬化无腹水患者、42例健康体检者行血清白蛋白、血清钠、PT、血浆醛固酮检查，对三组血醛固酮值进行对比分析，同时对肝硬化腹水组将腹内压与年龄、血清白蛋白、血清钠、PT、腹围呼吸差值、血浆醛固酮进行统计学分析，，得出以上指标的相关性（由于无法对无腹水组及健康对照组测腹内压，故这两组没有腹围呼吸差值及腹内压）。研究结果：肝硬化腹水组醛固酮值为484.57pg/ml±140.23pg/ml，肝硬化无腹水组醛固酮值为288.60pg/ml±116.05pg/ml，正常对照组醛固酮值为106.14pg/ml±48.26pg/ml，肝硬化腹水组醛固酮水平明显高于肝硬化无腹水组及正常对照组（p0.05），而肝硬化无腹水组及正常对照组无明显差异（p0.05）。肝硬化腹水患者腹内压与年龄、PT、血清钠、血清白蛋白无线性关系（p0.05），但与腹围呼吸差值相关（t=-10.532,p0.01）。肝硬化腹水组醛固酮值为216pg/ml-672pg/ml,平均为484.57pg/ml±140.23pg/ml，腹内压值为5.5-18厘米水柱，平均为10.75±3.53厘米水柱，腹内压与血浆醛固酮水平有线性关系（t=8.092，p=0.0230.05）。结论：（1）腹内压与腹围呼吸差值呈线性相关。（2）腹内压水平与血浆醛固酮水平呈线性相关。（3）肝硬化腹水患者血浆醛固酮水平明显高于肝硬化无腹水组及健康对照组。
[Abstract]:Background and objectives of the study:. China is a country with a high incidence of hepatitis B. ascites from liver cirrhosis is one of the most intolerable symptoms in patients with advanced liver cirrhosis. Therefore, the effective treatment of ascites is an important method to improve the quality of life in patients with advanced liver cirrhosis. Ascites of cirrhosis, especially refractory ascites, are still a difficult problem in clinical treatment. Although there are a variety of drugs and methods used in the treatment of refractory ascites in cirrhosis, the results are not optimistic. This study was designed to investigate the relationship between intra-abdominal pressure and age, serum albumin, serum natrium PTT, plasma aldosterone in patients with ascites due to cirrhosis. The relationship between intra-abdominal pressure and RAAS system provides theoretical basis for the treatment of ascites especially refractory ascites in patients with liver cirrhosis. Research methods:. The intraperitoneal pressure of 56 patients with ascites of cirrhosis diagnosed in our hospital was measured with a one-off glass manometry tube before the ascites were extracted. Serum albumin, serum sodium PTT, abdominal circumference respiratory difference, plasma aldosterone were measured simultaneously. At the same time, serum albumin, serum natrium PTT and plasma aldosterone were examined in 30 patients with cirrhosis without ascites and 42 healthy controls. The serum aldosterone values in the three groups were compared and analyzed. At the same time, the intra-abdominal pressure and age were compared in the cirrhotic ascites group. Serum albumin, serum natrium PTT, abdominal respiratory difference and plasma aldosterone were statistically analyzed. Therefore, the two groups did not have abdominal circumference respiratory difference and intraabdominal pressure. Results of the study:. Aldosterone was 484.57 PG / ml 卤140.23 PG / ml in cirrhotic ascites group, 288.60 PG / ml 卤116.05 PG / ml in cirrhosis without ascites group, 106.14 pg / ml 卤48.26 PG / ml in normal control group. The aldosterone level in cirrhosis ascites group was significantly higher than that in cirrhosis without ascites group and normal control group (P 0.05). There was no significant difference between non-ascites group and normal control group (P 0.05). The relationship between serum albumin and abdominal respiratory difference was p0.05, but there was a linear relationship between intra-abdominal pressure and plasma aldosterone level in cirrhotic ascites group (216pg / ml-672pg / ml, mean 484.57pg / ml 卤140.23pg / ml, mean 10.75 卤3.53cm water column, mean intra-abdominal pressure was 10.75 卤3.53cm / ml), and there was a linear relationship between intra-abdominal pressure and plasma aldosterone level in cirrhotic ascites group (484.57pg / ml 卤140.23pg / ml, mean 10.75 卤3.53cm / ml). Conclusion:. 1) the plasma aldosterone level in patients with ascites with cirrhosis was significantly higher than that in patients with cirrhosis without ascites and healthy controls.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R575.2

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