乙肝后肝硬化肝性脑病患者碳氧血红蛋白的临床意义

Detection of carboxyhemoglobin in hepatic encephalopathy of hepatitis B related cirrhosis

AIM: To reveal the significance of carboxyhemoglobin (COHb) on patients with hepatitis B related cirrhosis (HBC) along with hepatic encephalopathy (HE). METHODS: According to the diagnostic and excluding standards, 63 inpatients with HBC presenting with HE when admitted were enrolled as Group H. Patients in Group H whom regained mind with current medications, were regarded as Group P-H. 20 health volunteers were selected as control group (Group N). COHb levels of all the groups were available by arterial blood gas analyses. The incidences of hepatic renal syndrome (HRS), upper gastrointestinal bleeding, esophagogastric varices and spontaneous bacterial peritonitis (SBP) in Group H were recorded. Besides that, the data of partial pressure of oxygen (PaO2) and oxygen saturation (SaO2) in Group H were available. COHb levels of the three groups and of patients in Group H with complications and none were compared, respectively. The relationship of COHb levels in Group H among grades of HE, PaO2, SaO2 and hypoxemia were analyzed. RESULTS: The COHb level in Group H was higher than that in Group P-H and N (P<0.01), and that in Group P-H was increased than in Group C (P<0.01). COHb concentration has positive correlation with grades of HE (P= 0.004, r =0.357). There was no difference of COHb levels in HE patients inspite of complications such as esophagogastric varices or SBP (P>0.05). But the content of COHb was increased in HE patients without HRS comparison to those with HRS (P=0.029). COHb level had a negative correlation with PaO2 (P=0.007, r=-0.335) and no relationship to SaO2 (P>0.05). COHb concentration was higher when the two parameters met diagnostic criteria of hypoxemia (P=0.011). CONCLUSIONS: Carboxyhemoglobin could contribute to judge the severity and therapeutic effects for HE. Tissue-specific of carboxyhemoglobin levels were manifested in cirrhotic patients with different complications.