乙型肝炎后肝硬化合并肝性脑病的危险因素分析

目的 探讨乙型肝炎后肝硬化合并肝性脑病（HE）发生、发展的相关危险因素,为临床制定该病的防治策略提供经验.方法 对乙型肝炎后肝硬化合并HE患者64例（观察组）与乙型肝炎后肝硬化未合并HE患者53例（对照组）进行对比分析.结果 与对照组比较,观察组血氨、血清总胆红素、BUN水平和感染、上消化道出血发生率增高,血钠、ALT、血清白蛋白水平降低（t=3.085、5.528、7.126,χ^2=9.174、4.102,t=4.337、8.675、5.323,均P＜0.05）；高龄、≥3种诱因及C级肝功能是导致患者死亡的高危因素.在观察组死亡患者的诱因中,以感染最为常见（75.9%）,其次为上消化道出血（65.5%）.结论 高龄、危险诱因数量及肝功能严重程度是乙型肝炎后肝硬化合并HE发生和发展的相关危险因素,积极去除上述诱因是防治乙型肝炎后肝硬化合并HE的关键.

Analysis of risk factors of hepatitis B cirrhosis complicated with hepatic encephalopathy

Objective To investigate the hepatitis B liver cirrhosis complicated with hepatic encephalopathy （HE）,relevant risk factors in the development of strategies for the prevention and treatment of the disease,and make for the clinical experience accumulation.Methods A retrospective analysis of 64 cases of liver cirrhosis patients complicated with HE,for the observation group.In addition,53 patients of hepatitis B cirrhosis without HE patients were selected as control group.The two groups of patients with objective physiological indicators were recorded and compared.Results （1） Compared with the control group,blood ammonia,serum total bilirubin,blood urea nitrogen level and infection,incidence of digestive tract hemorrhage of the study group increased,blood sodium,alanine amin otrans ferase,decrease the serum albumin level,the differences were statistically significant （t =3.0 8 5,5.5 2 8,χ^2 =9.174,7.126,t =4.102,4.337,8.675,5.323,all P 〈0.05）.（2） For the patients in the study group,age,more than 3 kinds of incentives and C grade of liver function were the high risk factors of death.（3） In the cause of deaths in the study group,the infection was the most common,the incidence rate was 75.9%,the second above digestive rare tract hemorrhage,the incidence rate was 65.5%.Conclusion The elderly,the number of risk factors and severity of liver function are the occurrence and development of related risk factors of hepatitis B related cirrhosis with hepatic encephalopathy,to remove the incentive is the key of HE with prevention and treatment of hepatitis B cirrhosis.