發(fā)布時間：2018-03-10 20:12

  本文選題：肝硬化　切入點(diǎn)：醛固酮　出處：《南昌大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：研究背景和目的： 我國是一個乙肝高發(fā)的國家，肝硬化腹水是晚期肝硬化患者最難以忍受的癥狀之一，因而腹水的有效的治療對于晚期肝硬化患者是一種提高生存質(zhì)量的重要方法。肝硬化腹水特別是難治性腹水在臨床上仍是一個治療難題，雖然目前有多種藥物及方法運(yùn)用于肝硬化難治性腹水的治療，但效果仍不容樂觀。本研究旨在探討肝硬化腹水患者腹內(nèi)壓與年齡、血清白蛋白、血清鈉、PT、血漿醛固酮、腹圍呼吸差值的關(guān)系，得出腹內(nèi)壓與RAAS系統(tǒng)的相關(guān)性為肝硬化患者腹水的治療特別是難治性腹水的治療提供理論依據(jù)。 研究方法： 通過對56例我院確診的肝硬化腹水患者在抽腹水前用一次性玻璃測壓管測腹內(nèi)壓并同時行血清白蛋白、血清鈉、PT、腹圍呼吸差值、血漿醛固酮檢查，同時對30例我院確診的肝硬化無腹水患者、42例健康體檢者行血清白蛋白、血清鈉、PT、血漿醛固酮檢查，對三組血醛固酮值進(jìn)行對比分析，同時對肝硬化腹水組將腹內(nèi)壓與年齡、血清白蛋白、血清鈉、PT、腹圍呼吸差值、血漿醛固酮進(jìn)行統(tǒng)計(jì)學(xué)分析，，得出以上指標(biāo)的相關(guān)性（由于無法對無腹水組及健康對照組測腹內(nèi)壓，故這兩組沒有腹圍呼吸差值及腹內(nèi)壓）。 研究結(jié)果： 肝硬化腹水組醛固酮值為484.57pg/ml±140.23pg/ml，肝硬化無腹水組醛固酮值為288.60pg/ml±116.05pg/ml，正常對照組醛固酮值為106.14pg/ml±48.26pg/ml，肝硬化腹水組醛固酮水平明顯高于肝硬化無腹水組及正常對照組（p0.05），而肝硬化無腹水組及正常對照組無明顯差異（p0.05）。肝硬化腹水患者腹內(nèi)壓與年齡、PT、血清鈉、血清白蛋白無線性關(guān)系（p0.05），但與腹圍呼吸差值相關(guān)（t=-10.532,p0.01）。肝硬化腹水組醛固酮值為216pg/ml-672pg/ml,平均為484.57pg/ml±140.23pg/ml，腹內(nèi)壓值為5.5-18厘米水柱，平均為10.75±3.53厘米水柱，腹內(nèi)壓與血漿醛固酮水平有線性關(guān)系（t=8.092，p=0.0230.05）。 結(jié)論： （1）腹內(nèi)壓與腹圍呼吸差值呈線性相關(guān)。（2）腹內(nèi)壓水平與血漿醛固酮水平呈線性相關(guān)。（3）肝硬化腹水患者血漿醛固酮水平明顯高于肝硬化無腹水組及健康對照組。
[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 鹵140.23 PG / ml in cirrhotic ascites group, 288.60 PG / ml 鹵116.05 PG / ml in cirrhosis without ascites group, 106.14 pg / ml 鹵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 鹵140.23pg / ml, mean 10.75 鹵3.53cm water column, mean intra-abdominal pressure was 10.75 鹵3.53cm / ml), and there was a linear relationship between intra-abdominal pressure and plasma aldosterone level in cirrhotic ascites group (484.57pg / ml 鹵140.23pg / ml, mean 10.75 鹵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.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R575.2

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