腹水浓缩回输治疗失代偿期肝硬化患者肾血流和血清血管活性因子水平的变化

doi:10.3969/j.issn.1672-5069.2020.05.026

Abstract

Abstract: Objective The aim of this study was to observe the efficacy of ascites concentration and reinfusion (ACR) in treatment of patients with decompensated liver cirrhosis (DLC). Methods 102 patients with DLC and asciteswere admitted to our hospital between May 2016 and May 2018, and were divided into observation (n=60) and control (n=40) groups. The patients in the control were treated with routinesupporting therapy, and those in the observation were treated with ACR at base of general therapy. The maximum systolic and minimum diastolic blood flow velocities of main renal aorta (MRA), interlobular renal artery (IRA) and segmental renal artery (SRA) were measured by sonography. Serum levels of lipopolysaccharide (LPS), thromboxane (TX) , leukotriene (LT) ,aldosterone(ALD)and atrial natriuretic peptide (ANP) were detected. Results At the end of two week treatment,the 24-hour urine volume in the observation group was (1864.9±206.5) ml, significantly greater than 【(1050.7±186.2) ml, P < 0.05】, and the ascites subsidence time in the observation group was (13.8±4.5)d, significantly shorter than【(20.3±8.0)d, t = 5.011,P = 0.000】 in the control; the maximal systolic blood flow velocities of MRA, IRA and SRA inthe observation group were (75.5±9.0)cm/s,(37.2±4.4)cm/s and (56.4±5.7)cm/s, significantly quicker than 【(71.4±8.5)cm/s,(35.2±3.9)cm/s and (52.3±5.0)cm/s, P < 0.05】 in the control group; the lowest diastolic blood flow velocities of MRA, IRA and SRA were (25.7±3.6)cm/s,(16.3±3.1)cm/s and (14.9±2.7)cm/s,much quicker than 【(22.3±3.7)cm/s,(14.2±2.6)cm/s and (12.0±2.6)cm/s, P< 0.05】 in the control group; serum LPS, TX, LT and ALD levels in the observation were(10.6±1.8)pg/ml, (95.2±14.5)pg/ml, (88.4±7.7)pg/ml and (189.6±12.4)pg/ml, significantly lower than, while serum ANP level was (347.1±60.4)ng/L, much higher than in the control 【(13.2±2.1)pg/ml, (104.5±18.7)pg/ml, (94.7±8.5)pg/ml, (198.7±15.8)pg/ml and (271.3±44.7)ng/L, P<0.05】. Conclusion The ACR therapy for cirrhotic patients with ascites is Efficacious, which might be related to the improved renal blood flow and modulation of renal vasoactive factors.

Key words: Liver cirrhosis, Ascites concentration and reinfusion, Renal vasoactive factors, Renal blood flow, Therapy

He Liandong, Cao Shuqing, Han Can, et al.. Efficacy of ascites concentration and reinfusion in treatment of patients with decompensated liver cirrhosis[J]. Journal of Practical Hepatology, 2020, 23(5): 707-710.

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Efficacy of ascites concentration and reinfusion in treatment of patients with decompensated liver cirrhosis

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