肝硬化并发肾上腺皮质功能不全患者的临床特点分析

目的了解肝硬化患者的血清基础皮质醇及促肾上腺皮质激素（ACTH）水平,探讨肝硬化患者并发肾上腺皮质功能不全（AI）的临床意义及特点。方法 118例肝硬化患者用化学发光方法测量血清基础皮质醇及ACTH水平,然后将其分为并发AI组和未并发AI组,前瞻性地分析两组患者的临床特点及预后。同期选取30名胃肠息肉患者为对照组。结果本组肝硬化患者基础皮质醇水平为（329.67±136.1）nmol/L,显著低于对照组的（460.7±165.48）nmol/L（t=-4.501,P〈0.05）。肝硬化中并发AI者32例占27.1%（32/118）,AI组与未并发AI的肝硬化患者比较,在并发自发性腹膜炎（SBP...

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Bibliographic Details
Published in临床肝胆病杂志 Vol. 28; no. 5; pp. 364 - 367
Main Author 叶颖剑 胡乃中
Format Journal Article
LanguageChinese
Published 安徽医科大学第一附属医院消化内科,安徽合肥,230022 2012
Subjects
促肾上腺皮质激素
肝硬化
肾上腺皮质激素类
肾上腺皮质疾病
肾上腺皮质激素类
肾上腺皮质疾病
促肾上腺皮质激素
肝硬化
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ISSN1001-5256

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Summary:目的了解肝硬化患者的血清基础皮质醇及促肾上腺皮质激素（ACTH）水平,探讨肝硬化患者并发肾上腺皮质功能不全（AI）的临床意义及特点。方法 118例肝硬化患者用化学发光方法测量血清基础皮质醇及ACTH水平,然后将其分为并发AI组和未并发AI组,前瞻性地分析两组患者的临床特点及预后。同期选取30名胃肠息肉患者为对照组。结果本组肝硬化患者基础皮质醇水平为（329.67±136.1）nmol/L,显著低于对照组的（460.7±165.48）nmol/L（t=-4.501,P〈0.05）。肝硬化中并发AI者32例占27.1%（32/118）,AI组与未并发AI的肝硬化患者比较,在并发自发性腹膜炎（SBP）、Child分级、Child评分、MELD评分及病死率方面明显增高,两组差异有统计学意义（P〈0.05）;32例并发AI的肝硬化患者白蛋白、高密度脂蛋白-胆固醇（HDL-C）水平明显减低,出现面部色素沉着及腹水的发生率较高（P〈0.05）,然而其他临床特点及实验室指标,两组差异无统计学意义。结论肝硬化患者基础皮质醇水平明显减低,并发AI的患者SBP的发生率高、肝损伤的严重、病死率增加,严重影响预后。
Bibliography:liver cirrhosis; adrenal cortex diseases; adrenal cortex hormones; adrenocorticotrophic hormone
Objective To evaluate the baseline level of corticosteroid and adrenocorticotrophic hormone（ACTH） in patients with cirrhosis and to investigate the clinical characteristics in patients with cirrhosis complicated with adrenal insufficiency（AI）.Methods The basal level of corticosteroid and ACTH in 118 liver cirrhosis cases,who were hospitalized in the Department of Gastroenterology in our hospital were measured.Then the patients were divided into two groups as with or without AI.Clinical characteristics and prognosis of the two groups were analyzed.30 cases of gastrointestinal polypus were selected as control.Results The serum corticosteroid in 118 cirrhosis patients was（329.67±136.1） nmol/L,that was lower than that（460.7±165.48） nmol/L in the control group（t=-4.501,P0.05）.Of 118 cases of cirrhosis,there were 32 cases combining AI and the propotion of them was 27.1%（32/118）.In addition,spontaneous bacterial peritoniti
ISSN:1001-5256