Prevalence and risk factors for minimal hepatic encephalopathy in cirrhotic patients with different etiologies  

作　　者：Xiaoyan Li Shanghao Liu Huiling Xiang Qingge Zhang Ying Guo Hongmei Zu Jing Wang Jiaojian Lv Xiaoning Zhang Fanping Meng Jiahuan Li Jie Li Yangzhen Bianba Jia Shang Guo Zhang Fei Liu Zhaowei Tong Chuang Lei Wei Ye Qiaohua Yang Ningning Wang Ying Song Wei Fu Ziyue Li Yanjing Gao Yongping Zhang Jiafang Chen Caiyun Wu Qi Zheng Fang Wang Jiali Yu Lianjie Lin Chuanlong Yang Xiaoting Yang Xiaomin Ye Xiangmei Wang Xuelan Zhao Xiaolong Qi Fusheng Wang Junliang Fu 

机构地区：[1]Medical School of Chinese PLA,Beijing,China [2]National Clinical Research Center for Infectious Diseases,The Fifth Medical Center of Chinese PLA General Hospital,Beijing,China [3]The First School of Clinical Medicine of Lanzhou University,Lanzhou,Gansu,China [4]Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases,Department of Gastroenterology and Hepatology,Tianjin Third Central Hospital,Institute of Hepatobiliary Disease,Tianjin,China [5]Hepatology Department of Integrated Traditional Chinese and Western Medicine,Xingtai People's Hospital,Xingtai,Hebei,China [6]Department of Hepatology,The Third people's Hospital of Taiyuan,Taiyuan,Shanxi,China [7]Department of Gastroenterology,The Fourth People's Hospital of Qinghai Province,Xining,Qinghai,China [8]Department of Gastroenterology,The Second Affiliated Hospital of Baotou Medical College,Baotou,Inner Mongonia,China [9]Department of Infectious Disease,Lishui City People's Hospital,Lishui,Zhejiang,China [10]Department of Infectious Diseases,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei,China [11]Department of Infectious Diseases,Nanjing Drum Tower Hospital,The Affiliated Hospital of Medical School,Nanjing University,Nanjing,Jiangsu,China [12]Department of Hepatology,The Third People's Hospital of Tibet Autonomous Region,Lhasa,Xizang,China [13]Department of Infectious Diseases,Henan Provincial People's Hospital,Zhengzhou,Henan,China [14]Department of Gastroenterology,The People's Hospital of Guangxi Zhuang Autonomous Region,Nanning,Guangxi,China [15]Hunan Key Laboratory of Viral Hepatitis,Department of Infectious Diseases,Xiangya Hospital,Central South University,Changsha,Hunan,China [16]Department of Infectious Diseases,Huzhou Central Hospital,Huzhou,Zhejiang,China [17]Department of Infectious Diseases,The First People's Hospital of Changde City,Changde,Hunan,China [18]Liver Cirrhosis Treatment Center,Nanjing Hospital Affiliated to Nanjing University of Traditional Chinese Medicine,Nanjing,

出　　处：《Portal Hypertension & Cirrhosis》2023年第4期171-180,共10页门静脉高压与肝硬化（英文）

基　　金：The Innovation Groups of the National Natural Science Foundation of China,Grant/Award Number:81721002;Capital Clinical Diagnosis and Treatment Technology Research and Transformation Application Project,Grant/Award Number:Z201100005520046;Tianjin Key Medical Specialty Construction Project,Grant/Award Number:TJYXZDXK-034A;Tianjin Health Science and Technology Project,Grant/Award Number:TJWJ2022XK029。

摘　　要：Aims:Minimal hepatic encephalopathy(MHE)significantly affects the prognosis of patients with cirrhosis.This study was performed to determine whether there is a difference in the prevalence of MHE among patients with cirrhosis of different etiologies and whether the etiology directly influences the occurrence of MHE.Methods:This multicenter,cross-sectional study enrolled 1879 patients with confirmed cirrhosis at 40 hospitals from October 25,2021,to January 10,2023(Trial registration:https://clinicaltrials.gov/[NCT05140837]).The patients'demographics,etiologies of cirrhosis,and laboratory test results were collected.The psychometric hepatic encephalopathy score(PHES)was determined in all patients to screen for MHE.Multivariate logistic analyses were performed to identify the risk factors for MHE.Results:In total,736 patients with cirrhosis were analyzed.The prevalence of MHE was 42.0%(n=309).The primary etiology among all patients was hepatitis B virus(HBV)-related cirrhosis(71.9%[529/736]).The prevalence of MHE was significantly higher in patients with alcoholic cirrhosis(57.1%[40/70])than in those with HBV-related cirrhosis(40.6%[215/529],p=0.009)or hepatitis C virus(HCV)-related cirrhosis(38.2%[26/68],p=0.026).Age(odds ratio[OR],1.042;95%confidence interval[CI],1.024-1.059;p<0.001),duration of education(OR,0.935;95%CI,0.899-0.971;p=0.001),etiology(OR,1.740;95%CI,1.028-2.945;p=0.039),and high MELD-Na scores(OR,1.038;95%CI,1.009-1.067;p=0.009)were independent risk factors for MHE.When patients with cirrhosis of different etiologies were analyzed separately,the results showed that age(OR,1.035;95%CI,1.014-1.057;p=0.001)and duration of education(OR,0.924;95%CI,0.883-0.966;p=0.001)were risk factors for MHE among patients with HBV-related cirrhosis,whereas age(OR,1.138;95%CI,1.033-1.254;p=0.009)and creatinine concentration(OR,16.487;95%CI,1.113-244.160;p=0.042)were risk factors for MHE in patients with HCV-related cirrhosis.No risk factors for MHE were found in patients with autoimmune cirrhosis.For patients with alco

关 键 词：ETIOLOGY liver cirrhosis minimal hepatic encephalopathy psychometric hepatic encephalopathy score risk factors 

分 类 号：R575[医药卫生—消化系统]