's general knowledge of forming mechanism of the liver cirrhosis ascites

's general knowledge of forming mechanism of the liver cirrhosis ascites
The ascites is the most common in liver cirrhosis mainly amalgamates disease, it is relatively complicated for it to form the factor. Mainly liver cirrhosis portal vein causes high motive force to circulate, make effective blood capacity of the artery drop under high pressure, activate some the intersection of nerve and humoral factor and factor in the kidney subsequently, cause functional kidney and the intersection of water and sodium store, stay unusually. Cause the ascites.
First, door pulse and high pressure
Door pulse and high pressure are the main reason that the liver cirrhosis ascites is formed. Also liver cirrhosis portal vein hyperbarism loses the important sign compensated. Through measuring, after finding the ascites through treating and reducing, the blood flow volume of portal vein increases. Seldom form the ascites as the pressure of portal vein <12mmHg. Reviewing research indicates, the blanking skill compares with body by-pass surgery of the door. Probability takes place far higher than the latter in the former's ascites.
Door pulse high pressure hour. In some the intersection of blood vessel and active medium ' Such as NO) Under function. Can make the spleen arteriolar and expand extensively, the latter impels fi again intravenously and flows people quantity increases. Therefore has even set up collateral circulation. Pulse pressure can still obviously increase on the door. In addition, it cause the capillary high pressure of small intestine and increase of lymphocytic flow to be important factors that the ascites is formed that chronic pulse pressures increase.
Door pulse and high pressure and unusual relation that forms with the ascites of the renal function are got from three following respects definitely at least: It causes angiotensin and resists the sodium diuresis system to activate that pulse causes the spleen under high pressure and circulates and changes all over on the door, cause kidney sodium water to store and stay. Liver pressure increase, cause the intersection of liver and kidney reflect, lead to the fact the intersection of sodium and ink store, stay. Shunt, wind the intersection of spleen and material of area can produce the sodium retention effect in the kidney through the intersection of door and body.
Second, it is unusual to circulate
Liver cirrhosis patient's whole body is in circulating in high motive force state, the heart fights the exporting amount to obviously increase each time, tip blood vessel resistance and artery pressure reducing. The place where the resistance of blood vessel increases is the circulation of spleen at first, whether have arteriectasis and still have dispute in other blood vessel beds at this moment. It is generally acknowledged with the intersection of sound and the intersection of pulse and tight opening, vasodilation factor increase, have something to do horizontally reduce and circulate to the intersection of vasoconstrictor and sensitiveness. Glucagon in liver cirrhosis animal's model or the patient's blood plasma, the active small intestine of blood vessel polypeptide, prostaglandin f material, lowers calcium relevant polypeptide or blood platelet of plain gene to activate the factor to increase. In addition, liver cirrhosis patient's peripheral blood NO density is far higher than normal people, NO level is also higher than the peripheral vein in the blood of portal vein, brief on the spleen while circulating NO produces and obviously increases. If infuse NO to formate the reactive recovery of angiotensin that can make to suppress the factor and damage for the patient, NO formates, increases, plays an important role in arteriectasis when briefing on liver cirrhosis. Circulate, make effective the intersection of artery and capacity of blood vessel (EABV) unusually Insufficient, cause water to receive and store and stay.
Third, low albumin blood disease
The liver is the place of synthetic albumin. At the time of liver cirrhosis, because liver function is damaged chronically and continuously, the liver essence reduces and liver cellular metabolism obstacle, albumin is formated and obviously reduced, can present low albumin blood disease of blood plasma, make the liquid apt to leak people's abdominal cavity from the blood plasma, form the ascites.
Fourth, functional kidney is unusual
It is in short as the characteristic with water sodium retention and kidney blood vessel that the liver cirrhosis patient's functional kidney is unusual in later period.
1. Sodium retention It is that the earliest renal function of liver cirrhosis changes that sodium is held up in. Cause the ascites to produce directly. It can make the ascites disappear to arrange sodium clinically by limit sodium or with diuretic. And high sodium diet or diuretic will make the ascites reproduce to remove. Under the most basic treatment ' Lie in bed, low sodium diet) ,The patient tries the discharging amount of sodium best to burn 10mE q/ day can reach 4 life cycle on average. 5. The urine arranges diuresis of patient with much sodium effectually.
2. Water retention About 75% of the ascites patients have function obstacle of water drainage of kidney. It relates to the fact that secrete vasopressin, increases. Usually the water drainage obstacle appears after sodium is stored and stayed. The lighter can still drain off water normally. But take a photograph of water with presenting diluting hyponatremia disease and low and permeating to press in overload. Ascites patient invites liver cirrhosis but have spontaneous hyponatremia diseases (
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