非肝硬化门静脉高压患者肝性脑病影响因素分析

Analysis of influencing factors on hepatic encephalopathy in patients with non-cirrhotic portal hypertension

目的探讨非肝硬化门静脉高压(NCPH)患者肝性脑病(HE)发生情况,并探讨其危险因素。方法评价两所医院共150例NCPH患者HE的发生率,以188例代偿期肝硬化患者作为对照。采用logistic回归筛选NCPH患者发生HE的独立危险因素,计数资料比较采用χ2检验,计量资料比较采用方差分析。结果NCPH患者显性肝性脑病(OHE)的发生率与肝硬化患者的差异无统计学意义(4.7%与6.9%,P=0.682);轻微肝性脑病(MHE)的发生率显著低于肝硬化患者(32.7%与46.3%,P<0.05)。上消化道出血、感染及门静脉侧支循环形成是NCPH患者发生HE的主要独立危险因素(OR>1,P<0.05)。结论HE是NCPH重要的并发症之一,且可能受上消化道出血、感染及门静脉侧支循环形成等因素的影响。

Objective To investigate the incidence of hepatic encephalopathy (HE) in patients with non-cirrhotic portal hypertension (NCPH) and to explore its risk factors. Methods The incidence rate of HE in 150 cases with NCPH was evaluated in two hospitals, and 188 cases of compensated cirrhosis patients were taken as control. Logistic regression was used to screen for independent risk factors for HE in patients with NCPH. Results The incidence of overt hepatic encephalopathy (OHE) in patients with NCPH was not statistically significantly different from that in patients with cirrhosis (4.7% vs. 6.9%, P = 0.682). The incidence of mild hepatic encephalopathy (MHE) was significantly lower than that of cirrhosis patients (32.7% vs. 46.3%, P < 0.05). The presence of upper gastrointestinal bleeding, infection and portosystemic venous shunt were the main independent factors for HE in NCPH patients (OR > 1, P < 0.05). Conclusion HE is one of the important complications of NCP, and may be influenced by factors such as upper gastrointestinal bleeding, infection and portosystemic venous shunt.