The idtal time for selecting portal hypertension operation is the accurate judgement of the grade of liver function.yet the present criterion in grading liver functicn is controversial.tco pztitnts vith 20 factoxs rel...The idtal time for selecting portal hypertension operation is the accurate judgement of the grade of liver function.yet the present criterion in grading liver functicn is controversial.tco pztitnts vith 20 factoxs related to poxttl hypeitersor wexe undergone stepwise discriminant analysis by using SAS software on the IBM/PC computer(significance levtl α=0.05).The results show that ascites degree prothrombin tmie(PT),serum total bilirubin,serum albumin content,main portal vein flow are significant fators.In the light of above variates contributing to grading liver function as to estblish a discriminant eqation,it was found that the total agreement rate between replaceable discimination and original Child-Pugh classification is 86%.A test for agieement was performed between discriminant and original classificaton,showing that the two kinds of classification methods have a good agreement rates (Kppa=0.7856),indicating the discriminant classification is of practica values.展开更多
AIM: To study sleep aspects and parameters in cirrhotic patients and assess the role of liver dysfunction severity in polysomnographic results. METHODS: This was a case-control study. Patients with a diagnosis of live...AIM: To study sleep aspects and parameters in cirrhotic patients and assess the role of liver dysfunction severity in polysomnographic results. METHODS: This was a case-control study. Patients with a diagnosis of liver cirrhosis were consecutively enrolled in the study. Clinical examinations and laboratory liver tests were performed in all patients, and disease severity was assessed using the Child-Pugh score. The control group consisted of ageand gender-matched healthy volunteers. All individuals answered a questionnaire about habits, behaviors, and complaints related to sleep and were submitted to polysomnography. Sleep parameters were compared between the two groups, and separate analyses were performed among classesof Child-Pugh classification in the cirrhotic group. RESULTS: Forty-two cirrhotic patients and forty-two controls were enrolled. Compared to the control group, the cirrhotic group exhibited lower sleep efficiency (mean ± SD: 73.89% ± 14.99% vs 84.43% ± 8.55%, P < 0.01), increased latency (151.27 ± 93.24 min vs 90.62 ± 54.74 min, P < 0.01) and a lower percentage of rapid eye movement (REM) sleep (14.04% ± 5.64% vs 20.71% ± 6.77%, P < 0.05) as well as a higher frequency of periodic limb movements (10.56 ± 2.85/h vs 2.79 ± 0.61/h, P < 0.01). The comparison of sleep parameters among Child A, B and C cirrhotic patients revealed a significant reduction of REM sleep stage occurrence in individuals with severe liver disease (Child C patients) compared to Child A/B patients (polysomnography percentage of REM sleep stage of patients Child A: 16.1% ± 1.2%; Child B: 14.9% ± 1.2%; Child C: 8.6% ± 1.6%, P < 0.05). CONCLUSION: Cirrhosis was associated with shorter sleep time, reduced sleep efficiency, increased sleep latency, increased REM latency and reduced REM sleep. Additionally, disease severity influences sleep parameters.展开更多
文摘The idtal time for selecting portal hypertension operation is the accurate judgement of the grade of liver function.yet the present criterion in grading liver functicn is controversial.tco pztitnts vith 20 factoxs related to poxttl hypeitersor wexe undergone stepwise discriminant analysis by using SAS software on the IBM/PC computer(significance levtl α=0.05).The results show that ascites degree prothrombin tmie(PT),serum total bilirubin,serum albumin content,main portal vein flow are significant fators.In the light of above variates contributing to grading liver function as to estblish a discriminant eqation,it was found that the total agreement rate between replaceable discimination and original Child-Pugh classification is 86%.A test for agieement was performed between discriminant and original classificaton,showing that the two kinds of classification methods have a good agreement rates (Kppa=0.7856),indicating the discriminant classification is of practica values.
基金Supported by Grants from the Associao Fundo de Incentivo a Pesquisa and FAPESP-CEPID-Proc. 95/14303-3
文摘AIM: To study sleep aspects and parameters in cirrhotic patients and assess the role of liver dysfunction severity in polysomnographic results. METHODS: This was a case-control study. Patients with a diagnosis of liver cirrhosis were consecutively enrolled in the study. Clinical examinations and laboratory liver tests were performed in all patients, and disease severity was assessed using the Child-Pugh score. The control group consisted of ageand gender-matched healthy volunteers. All individuals answered a questionnaire about habits, behaviors, and complaints related to sleep and were submitted to polysomnography. Sleep parameters were compared between the two groups, and separate analyses were performed among classesof Child-Pugh classification in the cirrhotic group. RESULTS: Forty-two cirrhotic patients and forty-two controls were enrolled. Compared to the control group, the cirrhotic group exhibited lower sleep efficiency (mean ± SD: 73.89% ± 14.99% vs 84.43% ± 8.55%, P < 0.01), increased latency (151.27 ± 93.24 min vs 90.62 ± 54.74 min, P < 0.01) and a lower percentage of rapid eye movement (REM) sleep (14.04% ± 5.64% vs 20.71% ± 6.77%, P < 0.05) as well as a higher frequency of periodic limb movements (10.56 ± 2.85/h vs 2.79 ± 0.61/h, P < 0.01). The comparison of sleep parameters among Child A, B and C cirrhotic patients revealed a significant reduction of REM sleep stage occurrence in individuals with severe liver disease (Child C patients) compared to Child A/B patients (polysomnography percentage of REM sleep stage of patients Child A: 16.1% ± 1.2%; Child B: 14.9% ± 1.2%; Child C: 8.6% ± 1.6%, P < 0.05). CONCLUSION: Cirrhosis was associated with shorter sleep time, reduced sleep efficiency, increased sleep latency, increased REM latency and reduced REM sleep. Additionally, disease severity influences sleep parameters.
