血氨浓度与肝硬化患者Child-pugh分级、意识障碍程度的临床研究

目的研究肝性脑病患者血氨浓度与Child-Pugh分级、意识障碍程度之间的关系,探讨血氨对意识障碍的影响程度。方法对103例肝性脑病患者分别进行血氨浓度检测、意识障碍评估和肝功能的child-pugh评分,比较血氨浓度在不同意识障碍及child-pugh分级中的差异。结果肝功能Child-pugh分级B、C级患者的血氨浓度(76.84±23.85mmol/L、89.88±30.32mmol/L)明显高于A级(46.82±12.78mmol/L),P<0.05;轻度肝昏迷患者血氨浓度(30.86士18.75mmol/L)明显低于中度(71.88士12.78mmol/L)及重度昏迷患者(85.26士24.38mmol/L),P<0.05;Child-pughA、B级患者,血氨浓度在不同的意识障碍程度分组中差异有显著性(P<0.05;P<0.01);Child-pughC级患者血氨浓度在不同意识障碍分组中差异无显著性P>0.05。结论血氨与肝功能分级密切相关,血氨浓度与意识障碍水平密切相关,在肝功能Child-pughA、B级肝硬化患者,意识障碍水平随血氨浓度升高而加重,Child-pughC级肝硬化患者意识障碍程度与血氨浓度无明显相关性。

ObjectTo study the relationship between blood ammonia concentration and Child-Pugh classification and degree of disturbance of consciousness in patients with hepatic encephalopathy.MethodCompareBlood ammonia concentration with different levels of consciousness and child-pugh classification in 103 patients with hepatic encephalopathy.Result Child-pugh grade B,C group of blood ammonia concentration was significantly higher than the A group.blood ammonia concentration in Mild hepatic coma was significantly lower than moderate and severe group.In the Child-pugh Class A and B groups,The higher the concentration of ammonia,the heavier the degree of coma.There was no significant correlation between Child-pugh C grade blood ammonia concentration and hepatic coma.Conclusion Blood ammonia is closely related to the classification of liver function.Blood ammonia concentration is closely related to the level of disturbance of consciousness.Child-pughA B grade cirrhosis and blood ammonia concentration are positively correlated with the level of disturbance of consciousness,and the relationship between blood ammonia concentration and disturbance of consciousness No relevance.