Analysis of the Risk Factors Influencing the Morbidity and the Prognosis of Hepatic Encephalopathy
|School||Dalian Medical University|
|Course||Digestion within the science|
|Keywords||Hepatic encephalopathy Liver cirrhosis Prognosis Child-Pugh classification Risk factor|
Objective: Hepatic encephalopathy(HE) is the common complication and the major death cause of liver cirrhosis. This paper is to investigate the correlated factors influencing the morbidity of hepatic encephalopathy and the risk factors influence the prognosis of hepatic encephalopathy, in order to improve the accuracy of the diagnosis and the prognostic value of HE, and to guide clinical treatment.Methods: One hundred and twenty hospitalzed patients with liver cirrhosis were selected from the Second Affiliated Hospital of Dalian Medical University from December 2008 to October 2010. Sixty cases of them were liver cirrhosis with HE,and the other 60 cases were liver cirrhosis without hepatic encephalopathy(LC)which were drawn from 375 cases of LC randomly; and according to their prognosis,sixty HE cases were divided into alive group(HEa) and dead group(HEb).The clinical data of 120 cases were analyzed retrospectively,according to the patients’complaint and physical sign after their admission, monitoring enzyme, ALB, TB, TBA, PT, PTA, UREA, CREA, serum electrolytes, blood glucose, blood fat, blood gas, serum ammonia, blood routine, blood clotting function, ultrasound index:such as the diameter of portal vein and splenic vein and ascites, judging Child-Pugh classification and hepatic encephalopathy classification. The data were analyzed by SPSS 17.0 statistical analysis software. Chi-square test was used to analyze the difference of sex,ascites,acid-base disturbance between HE and LC,T-test was used to analyze the difference of age, hepatic function, renal function, serum electrolytes, blood glucose, blood fat, blood gas, serum ammonia, blood routine, blood clotting function, the diameter of portal vein and splenic vein between HE and LC,and P<0.05 was considered statistically significant. As the same statistical way to analyze the difference of various indexes between HEa and HEb, then the index which was considered statistically significant was admitted to the Binary Logistic Regression to analyze the risk factors influencing the prognosis of hepatic encephalopathy.Result:1.The percentage of baseosis was higher in HE than LC (P<0.05);The patients of HE had higher values of PT, serum ammonia, TBA, WBC, blood glucose, TB than LC(P<0.05), and had lower values of ALB,PTA,CHOL,serium Na+,TRIG than LC(P<0.05).2.The indexes of sex, age, ascites, ALT, AST, GGT, UREA, CREA serium K+, percentage of Ne, the diameter of portal vein and splenic vein had no significant difference between HE and LC.(P>0.05).3.The indexes of CREA, hepatic encephalopathy classification, PH, Child-Pugh Score, UREA, CHOL,TRIG,WBC had significant difference between HEa and HEb (P<0.05);and age, sex, ascites, ALT, AST, GGT, TB, TBA, ALB, PT, PTA, serium Na+, serium K+, blood glucose, serum ammonia , percentage of Ne, PO2, PCO2, the diameter of portal vein and splenic vein, Child-Pugh classification had no significant difference between the two groups.4.The three indexes of serum creatinine, hepatic encephalopathy classification, CHOL were related with the prognosis of Hepatic encephalopathy; serum cratinine, hepatic encephalopathy classification were positive correlation to hepatic encephalopathy, and CHOL was negative correlation to hepatic encephalopathy.Conclusions:1.The indexes of ALB, PT, PTA, serum ammonia, PH, CHOL, TBA, serium Na+, WBC, blood glucose, TRIG, TB of the patients with hepatic cirrhosis are related to the morbidity of hepatic encephalopathy.2.serum cratinine ,hepatic encephalopathy classification, CHOL can be used as effective indicators to determine prognosis of hepatic encephalopathy.