肝硬化患者肝性脑病发生风险的回顾性研究

王娜; 李娟; 李霞; 梁露文; 王小梅

doi:10.16016/j.1000-5404.201901048

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肝硬化患者肝性脑病发生风险的回顾性研究

临床医学 | 更新时间：2026-01-09

- 肝硬化患者肝性脑病发生风险的回顾性研究
- Risk factors for hepatic encephalopathy in patients with liver cirrhosis: a retrospective study
- 第三军医大学学报 2019年41卷第9期页码：885-890
- 作者机构：
  
  1.400010 重庆，重庆医科大学附属第二医院:肝胆外科
  2.400010 重庆，重庆医科大学附属第二医院:消化内科
  3.400010 重庆，重庆医科大学附属第二医院:感染病科
- 作者简介：
  
  [王小梅，E-mail:2986440387@qq.comWANG Xiaomei, E-mail:2986440387@qq.com
- 基金信息：
  
  重庆市卫生和计划生育委员会医学科研计划面上项目(2017MSXM032)
- DOI：10.16016/j.1000-5404.201901048
  中图分类号： R181.23;R575.2;R747.9
- 收稿：2019-01-07，
  
  修回：2019-02-17，
  
  纸质出版：2019-05-15
- 稿件说明：
移动端阅览
王娜, 李娟, 李霞, 等. 肝硬化患者肝性脑病发生风险的回顾性研究[J]. 第三军医大学学报, 2019,41(9):885-890.

Na WANG, Juan LI, Xia LI, et al. Risk factors for hepatic encephalopathy in patients with liver cirrhosis: a retrospective study[J]. Journal of Third Military Medical University, 2019, 41(9): 885-890.
王娜, 李娟, 李霞, 等. 肝硬化患者肝性脑病发生风险的回顾性研究[J]. 第三军医大学学报, 2019,41(9):885-890. DOI： 10.16016/j.1000-5404.201901048.

Na WANG, Juan LI, Xia LI, et al. Risk factors for hepatic encephalopathy in patients with liver cirrhosis: a retrospective study[J]. Journal of Third Military Medical University, 2019, 41(9): 885-890. DOI： 10.16016/j.1000-5404.201901048.

摘要

目的

探讨肝硬化患者发生肝性脑病的危险因素。

方法

选取本院2016年6月至2018年6月确诊为肝性脑病的188例肝硬化患者作为病例组，且以1:1的比例采用随机数字表抽取同期188例肝硬化无肝性脑病患者作为对照组，分析两组肝硬化患者发生肝性脑病的危险因素。

结果

单因素分析发现两组病因、肝性脑病病史、肝衰竭、高蛋白饮食、腹膜炎、败/脓毒血症、碱中毒、低氯血症、低钠血症、总胆红素(TBil)、直接胆红素(DBil)、国际化标准比值(INR)、终末期肝病模型(model for end stage liver disease，MELD)评分等比较，差异具有统计学意义(

0.05)。多因素分析发现肝性脑病病史、高蛋白饮食、碱中毒、MELD评分是肝硬化患者发生肝性脑病的独立危险因素(

0.05)

前白蛋白是其保护性因素(

0.05)。

结论

肝功能严重损害、肝性脑病病史、高蛋白饮食及碱中毒等危险因素可增加肝硬化患者肝性脑病发生风险，应及时进行评估与管理。

Abstract

Objective

To explore the risk factors associated with hepatic encephalopathy in patients with cirrhosis.

Methods

A total of 188 cirrhotic patients diagnosed with hepatic encephalopathy admitted in our hospital during June 2016 and June 2018 were enrolled and assigned into case group

another 188 cirrhotic patients without hepatic encephalopathy were subjected at a ratio of 1:1 and assigned into the control group. The risk factors for hepatic encephalopathy were analyzed based on the clinical data of the 2 groups of patients.

Results

Univariate analysis found that there were significant differences among cause of disease

history of hepatic encephalopathy

liver failure

high protein diet

peritonitis

sepsis

alkalosis

hypochloremia

hyponatremia

total bilirubin

direct bilirubin

international normalized ratio

and model for end stage liver disease (MELD) score (

0.05). And multivariate analysis

alkalosis indicated that history of hepatic encephalopathy

high protein diet

alkalosis

and MELD score were independent risk factors for the hepatic encephalopathy

but prealbumin was a protective factor (

0.05).

Conclusion

Serious liver damage

history of hepatic encephalopathy

high protein diet

and alkalosis can increase the risk of hepatic encephalopathy in cirrhotic patients

and they should be evaluated and managed timely.

关键词

Keywords

references

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