CAJ | 학술논문

目的：探讨急性心功能不全患者并发血氨升高的临床分析，提高对血氨轻度增高引起嗜睡的认识。方法回顾性分析总结12例急性心功能不全患者并发血氨升高的住院患者的临床资料。结果本组观察的患者血氨在80~120μmol/L，轻度增高出现嗜睡的症状。结论急性心功能不全患者易引起肝功能受损可导致血氨升高；肾脏供血减少，肾小管上皮细胞中谷氨酰胺分解产生的氨增多；患者需要卧床休息同时肠道淤血使肠蠕动减慢，易发生便秘使血氨吸收增多，使血氨在短期内升高引起嗜睡，要早期发现早期治疗。
목적：탐토급성심공능불전환자병발혈안승고적림상분석，제고대혈안경도증고인기기수적인식。방법회고성분석총결12례급성심공능불전환자병발혈안승고적주원환자적림상자료。결과본조관찰적환자혈안재80~120μmol/L，경도증고출현기수적증상。결론급성심공능불전환자역인기간공능수손가도치혈안승고；신장공혈감소，신소관상피세포중곡안선알분해산생적안증다；환자수요와상휴식동시장도어혈사장연동감만，역발생편비사혈안흡수증다，사혈안재단기내승고인기기수，요조기발현조기치료。
Objective To discuss the clinical analysis of acute heart failure patients with elevated blood ammonia, understanding of drowsiness caused by slightly elevated blood ammonia was improved.Methods Clinical data of 12 hospitalized patients of acute heart failure patients with elevated blood ammonia was retrospectively analyzed.Results Ammonia in this group of patients was 80-120 μmol/L, patients with ammonia slightly increased appeared drowsiness symptoms.Conclusion The following reasons could lead to elevated blood ammonia in patients with acute heart failure:①liver dysfunction can lead to elevated blood ammonia,②because of reduced blood supply to the kidney, renal tubular epithelial cells glutamine decomposition of ammonia increased,③patients require prolonged bed rest while intestinal congestion making bowel movements slow, prone to constipation, increased absorption of the ammonia, the ammonia elevated in the short term cause drowsiness, should be caught and treated early.