Clinical Characteristics And Therapeutic Analysis Of 138 Patients With Hepatorenal Syndrome And The Diagnostic Value Of Serum Cystatin C

Objective: To investigate the clinical characteristics of patients with liver cirrhosis complicated with hepatorenal syndrome(HRS),the clinical efficacy of three different treatment regimens,and the diagnostic value of serum cystatin C(CysC)in HRS,so as to provide a reference for clinical work.Methods: A retrospective analysis was performed on 138 patients with liver cirrhosis complicated with HRS and 140 patients without liver cirrhosis complicated with HRS admitted to our hospital from 2012 to 2018.Blood creatinine and urine volume were used to evaluate the efficacy of three different HRS treatment regimens: diuretic therapy was strengthened only,diuretic therapy was discontinued only,and diuretic therapy was appropriate on the basis of diuretic therapy.To evaluate the diagnostic value of CysC in HRS.Results: Posthepatitis b cirrhosis and alcoholic cirrhosis are the main primary diseases of cirrhosis with HRS and cirrhosis without HRS.Patients with cirrhosis complicated with HRS have a higher incidence of complications than those without HRS.Enhanced diuretic therapy alone may induce HRS in cirrhosis,or aggravate the increase of serum creatinine in patients with cirrhosis complicated with HRS.On the basis of diuresis,appropriate diuresis is more effective in reducing blood creatinine and increasing urine volume in patients with cirrhosis complicated with HRS than diuresis alone.The sensitivity and specificity of CysC in diagnosing HRS were higher than those of Scr.Conclusion: Liver cirrhosis with HRS is often associated with upper gastrointestinal bleeding,hepatic encephalopathy,infection and other complications.Once found,treatment measures should be taken actively,and laboratory examination results and urine volume of patients should be closely monitored.Enhanced diuresis alone may aggravate HRS.Appropriate diuresis on the basis of diuresis is more effective than discontinuation of diuresis.Serum Cysc has better diagnostic value for HRS than Scr.