定义 肝肾综合征(HRS)是指急性或慢性严重肝病患者发生的肾功能衰竭,肾脏在病理上缺乏明显变化,诊断时需排除肝病患者发生肾功能衰竭的其他原因,如低血容量、药物性肾中毒、脓毒血症或肾小球肾炎。 一、诊断标准 国际腹水协会于1996年制定的HRS诊断标准如下:①慢性或急性肝病伴进展性肝功能衰竭和门脉高压;②低肾小球滤过率(GFR),血清肌酐含量>225μmol/L或肌酐清除率<40ml/min;③无休克、细菌感染或最近未应用肾毒性药物,无过量体液丢失(包括胃肠道出血);④1.5L等渗生理盐水扩容后肾功能不能持续改善;⑤尿蛋白<0.5g/ Definitions Hepatorenal syndrome (HRS) refers to renal failure occurring in patients with acute or chronic severe liver disease, with a marked absence of pathological changes in the kidney and other causes of renal failure in patients with liver disease to be diagnosed, such as hypovolemia, medication Nephrotoxicosis, sepsis or glomerulonephritis. First, the diagnostic criteria International ascites Association in 1996 to develop the diagnostic criteria for HRS are as follows: ① chronic or acute liver disease with progressive liver failure and portal hypertension; ② low glomerular filtration rate (GFR), serum creatinine> 225μmol / L or creatinine clearance <40ml / min; ③ no shock, bacterial infection or no recent application of nephrotoxic drugs, no excessive fluid loss (including gastrointestinal bleeding); ④ 1.5L isotonic saline dilatation renal function can not be sustained Improve; ⑤ urinary protein <0.5g /