肝性脊髓病的病因、临床特征以及预后转归  

Analysis of etiology,clinical features and prognosis of hepatic myelopathy

作　　者：苏德巴彦尔·苏布达 吴喜德 乌敦高娃 Sudbayan er Subuda;WU Xi-de;Udungova(Baotou Mongolian Traditional Chinese Medicine Hospital,Inner Mongolia 014040,China)

机构地区：[1]包头市蒙医中医医院,内蒙古014040

出　　处：《肝脏》2025年第1期74-77,共4页Chinese Hepatology

基　　金：内蒙古自然基金(2020MS0835)。

摘　　要：目的探讨肝性脊髓病(hepatic myelopathy,HM)的病因、临床特征以及预后转归。方法选取2016年4月—2022年5月期间包头市蒙医中医医院诊治肝硬化患者49例,根据是否存在肝性脊髓病分为HM组(n=24)和非HM组(n=25),HM组患者根据预后情况分为好转组(n=6)和非好转组(n=18)。分析HM患者和非HM患者病因,比较好转组和非好转组患者临床资料。结果HM患者和非HM患者病因差异无统计学意义,乙型肝炎为肝性脊髓病最常见的病因(54.2%)。好转组患者CHE水平和Child-Pugh分级B级比例分别为(3597.7±1194.5)U/L和83.3%,显著高于非好转组[(1953.8±863.4)U/L和22.2%]。结论乙型肝炎为肝性脊髓病最常见的病因,肌力下降是肝性脊髓病患者最常见的临床表现,CHE水平和Child-Pugh分级可反映患者的预后情况。Objective To explore the etiology,clinical features and prognosis of hepatic myelopathy(HM).Methods Forty-nine patients with liver cirrhosis admitted to Baotou Mongolian Traditional Chinese Medicine Hospital between April 2016 and May 2022 were divided into HM group(n=24)and non-HM group(n=25)according to the presence of HM.HM group was divided into improvement group(n=6)and non-improvement group(n=18)according to prognosis.The etiologies of HM patients and non-HM patients were compared and the clinical data of improvement group and non-improvement group were compared.Results There was no significant difference when comparing the etiology of HM patients with that of non-HM patients.Hepatitis B was the most common cause of HM(54.2%).Comparing the clinical data of the patients in the improvement group and the non-improvement group,the CHE level and the proportion of Child-Pugh grade B in the improvement group were(3597.7±1194.5)U/L and 83.3%respectively,which were significantly higher than that of non-improvement group[(1953.8±863.4)U/L and 22.2%].Conclusion Hepatitis B is the most common cause of HM,and decreased muscle strength is the most common clinical manifestation in patients with hepatic myelopathy.CHE level and Child-Pugh grade may reflect the prognosis of patients.

关 键 词：肝性脊髓病 病因 预后 

分 类 号：R575[医药卫生—消化系统] R744[医药卫生—内科学]