急性心功能不全患者血氨轻度增高引起嗜睡的临床分析

摘要

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.%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。