Liver Research Laboratories, Pomeranian Medical University, Szczecin, Poland.
Ann Hepatol. 2013 May-Jun;12(3):448-55.
Hyponatremia is associated with high mortality and predicts hepatic encephalopathy but its effect on health-related quality of life remains to be established.
In this study we prospectively analyzed the relationship between hyponatremia, clinical features and quality of life in a cohort of 116 patients with cirrhosis. Chronic Liver Disease Questionnaire and Medical Outcomes Study 36- Item Short Form Health Survey were performed to assess quality of life. Evaluation of hepatic encephalopathy included West-Haven criteria, Psychometric Hepatic Encephalopathy Score and Critical Flicker Frequency analysis. Severity of liver disease was assessed with Child-Pugh score and MELD. Univariate and multivariate analysis were implemented to evaluate the influence of analyzed factors on quality of life.
Multivariate analysis has identified serum natremia, Psychometric Hepatic Encephalopathy Score, Critical Flicker Frequency and severity of liver disease measured with MELD and Child-Pugh score as independent factors affecting quality of life in patients with cirrhosis. West Heaven criteria failed to show the relationship with quality of life in analyzed subjects. Serum kalemia showed correlation with neither quality of life, hepatic encephalopathy nor severity of the disease.
In patients with cirrhosis serum natremia along with severity of liver disease and hepatic encephalopathy exerts a significant effect on patients' quality of life.
低钠血症与高死亡率相关，并可预测肝性脑病，但它对健康相关生活质量的影响仍有待确定。
在这项研究中，我们前瞻性地分析了 116 例肝硬化患者队列中低钠血症、临床特征和生活质量之间的关系。采用慢性肝病问卷和医疗结局研究 36 项简明健康调查评估生活质量。肝性脑病的评估包括 West-Haven 标准、心理测量性肝性脑病评分和临界闪烁频率分析。采用 Child-Pugh 评分和 MELD 评估肝功能严重程度。采用单因素和多因素分析评估分析因素对生活质量的影响。
多因素分析确定血清钠、心理测量性肝性脑病评分、临界闪烁频率以及用 MELD 和 Child-Pugh 评分测量的肝功能严重程度是影响肝硬化患者生活质量的独立因素。West Heaven 标准未能显示与分析对象生活质量的关系。血清钾与生活质量、肝性脑病或疾病严重程度均无相关性。
在肝硬化患者中，血清钠水平以及肝功能严重程度和肝性脑病与患者的生活质量有显著相关性。
