CAJ | 학술논문

目的探讨不限钠饮食与限钠饮食对肝硬化腹水患者血浆肾素(PRA)、血管紧张素Ⅱ(AII)、醛固酮(ALD)、肾血流量(RBF)和腹水消退的影响.方法 80例乙型肝炎肝硬化腹水患者随机分为不限钠饮食和限钠饮食两组,不限钠饮食组39例,每日氯化钠6500～ 8000 mg,限钠饮食组41例,每日氯化钠5000 mg,两组患者均用呋塞米、螺内酯利尿,比较治疗后血钠、尿钠、PRA、AII、ALD、RBF和腹水消退的情况.结果不限钠饮食组治疗10 d后血钠、尿钠、尿量较治疗前增多,也较限钠饮食组治疗10 d后增多,PRA、AII、ALD较治疗前降低,也较限钠饮食组治疗后10 d降低,P＜0.01,肾血流量较治疗前增多,也较限钠饮食组治疗后10 d增多,P＜0.01,治疗后低血钠诱发肾功能损害,不限钠饮食组少于限钠饮食组,P ＜0.05,至出院时腹水消失,不限钠饮食组多于限钠饮食组,P＜0.01,腹水消失时间,不限钠饮食组短于限钠饮食组,P＜0.01.结论与限钠饮食比较,在使用利尿剂同时,不限钠饮食能增加血钠水平,因而增加尿钠排泄,能增加利尿效果,并能降低PRA、AII、ALD水平,增加肾血流量,防止低血钠诱发肾功能损害,因而有利于腹水消退.
목적 탐토불한납음식여한납음식대간경화복수환자혈장신소(PRA)、혈관긴장소Ⅱ(AII)、철고동(ALD)、신혈류량(RBF)화복수소퇴적영향.방법 80례을형간염간경화복수환자수궤분위불한납음식화한납음식량조,불한납음식조39례,매일록화납6500～ 8000 mg,한납음식조41례,매일록화납5000 mg,량조환자균용부새미、라내지이뇨,비교치료후혈납、뇨납、PRA、AII、ALD、RBF화복수소퇴적정황.결과 불한납음식조치료10 d후혈납、뇨납、뇨량교치료전증다,야교한납음식조치료10 d후증다,PRA、AII、ALD교치료전강저,야교한납음식조치료후10 d강저,P＜0.01,신혈류량교치료전증다,야교한납음식조치료후10 d증다,P＜0.01,치료후저혈납유발신공능손해,불한납음식조소우한납음식조,P ＜0.05,지출원시복수소실,불한납음식조다우한납음식조,P＜0.01,복수소실시간,불한납음식조단우한납음식조,P＜0.01.결론 여한납음식비교,재사용이뇨제동시,불한납음식능증가혈납수평,인이증가뇨납배설,능증가이뇨효과,병능강저PRA、AII、ALD수평,증가신혈류량,방지저혈납유발신공능손해,인이유리우복수소퇴.
Objective To explore influence of sodium restricted diet and non-sodium restricted diet on plasma rennin (PRA),angiotensin Ⅱ (AII),ALD,renal blood flow (RBF) and subside of ascites in patients with cirrhotic ascites.Methods Eighty cases of hepatitis B with cirrhotic ascites were randomly divided into sodium restricted diet group and non-sodium restricted diet group.39 cases were in non-sodium restricted diet group,taking sodium chloride 6500-8000 mg daily; 41 cases were in sodium restricted diet group,taking sodium chloride 5000 mg daily.Both groups received diuretics furosemide and spironolactone.Blood sodium,urine sodium,PRA,AII,ALD,RBF ascites subsiding were compared after treatment.Results In non-sodium restricted diet group,blood sodium and urine sodium increased 10 days after treatment compared with those before treatment,and compared with those of sodium restricted diet group 10 days after treatment,P ＜ 0.01.RBF increased compared with that before treatment,and compared with that of sodium restricted diet group 10 days after treatment,P ＜ 0.01.Renal damage induced by low blood sodium after treatment was less in non-sodium restricted diet group than that in sodium restricted diet group,P ＜0.05.Ascites disappearance upon discharge was more in sodium restricted diet group than that in nonsodium restricted diet group,P ＜0.01.Time of ascites disappearance was shorter in non-sodium restricted diet group than that in sodium restricted diet group,P ＜ 0.01.Conclusion Compared with sodium restricted diet,while using diuretics of both groups,non-sodium restricted diet can increase level of blood sodium,thus increasing excretion of urine sodium and diuretic effect.It can also decrease levels of PRA,AII and ALD,increase renal blood flow and prevent renal damage induced by low blood sodium and facilitate subsiding of ascites.