The Relationship Between The Characteristics Of Acid-base Disorders And Prognosis In Liver Cirrhosis

Aims: The aim of this study was to investigate the relationship between the characteristics of acid-base disorders and prognosis in patients with liver cirrhosis.Methods: Arterial blood gases, electrolytes, the severity of cirrhosis (including Child-pugh score) and clinical information were measured in 278 patients with liver cirrhosis.Results: 199 patients had acid-base disorders (72.6%), the prevalence rate in respiratory alkalosis complicated with metabolic alkalosis, respiratory alkalosis and respiratory alkalosis complicated with metabolic acidosis were 23%, 14.7% and 11.5% respectively, and they were the acid-base disorders seen most frequently in liver cirrhosis. A significantly lower arterial oxygen tension and lower serum albumin concentration were found in patients with acid-base disorders which respiratory alkalosis were predominant than patients without acid-base disorder, (t were 2.538 and 3.319, P were 0.012 and 0.001, respectively), Analysis with logistic regression model revealed PaO2 and serum albumin concentration associated obviously with occurrence of acid-base disorders which respiratory alkalosis were predominant. Low arterial oxygen tension, low serum albumin concentration and low serum potassium concentration were found in patients with acid-base disorders which metabolic alkalosis werepredominant. ( t were 3.185, 3.302 and 3.238, P were 0.024, 0.001 and 0.002, respectively). Analysis with logistic regression model revealed serum potassium concentration and serum albumin concentration associated obviously with occurrence of acid-base disorders which metabolic alkalosis were predominant. Low arterial oxygen tension occured in patients with acid-base disorders which metabolic acidosis were predominant, (t =3.185, P=0.044). Furthermore, the mortality increased with the seriousness of acid-base disorder. Analysis with logistic regression model revealed PaO2 and PaCO2 associated obviously with prognosis of acid-base disorders in liver cirrhosis.Conclusions: 1 .Acid-base disorders are common clinical complications in patients with liver cirrhosis. 2. Respiratory alkalosis complicated with metabolic alkalosis or acidosis and respiratory alkalosis were the main features of acid-base disorders in patients with liver cirrhosis. 3. And we should pay attention at low arterial oxygen tension, low serum potassium concentration, hypoalbuminemia as we deduced that they were the risk factors for acid-base disorders in patients with liver cirrhosis. 4.The prognosis of liver cirrhosis is associated with acid-base disorders, low PaCO2, and low PaO2. 5. PaCO2 and PaO2 should be observed dynamically for decompensated cirrhosis as they were associated obviously with prognosis of acid-base disorders in liver cirrhosis. 6. Hypoxemia and hypoproteinemia should be treated in cirrhosis with acid-base disorders which can improve the prognosis and the quality of life.