Iwasa Motoh, Sugimoto Ryosuke, Mifuji-Moroka Rumi, Hara Nagisa, Yoshikawa Kyoko, Tanaka Hideaki, Eguchi Akiko, Yamamoto Norihiko, Sugimoto Kazushi, Kobayashi Yoshinao, Hasegawa Hiroshi, Takei Yoshiyuki
Department of Gastroenterology and Hepatology, Graduate School of Medicine, Mie University, Edobashi 2-174, Tsu, Mie, 514-8507, Japan.
Nutrition Unit, Mie University Hospital, Tsu, Japan.
Metab Brain Dis. 2016 Oct;31(5):1151-6. doi: 10.1007/s11011-016-9862-6. Epub 2016 Jun 29.
The aim of this study was to clarify the relationships among psychometric testing results, blood ammonia (NH3) levels, electrolyte abnormalities, and degree of inflammation, and their associations with the development of overt hepatic encephalopathy (HE) in liver cirrhosis (LC) patients. The relationships between covert HE and blood NH3, sodium (Na), and C-reactive protein (CRP) were examined in 40 LC patients. The effects of elevated NH3, hyponatremia, and elevated CRP on the development of overt HE were also investigated. The covert HE group had significantly lower serum Na levels and significantly higher serum CRP levels. During the median observation period of 11 months, 10 patients developed overt HE, and the results of multivariate analysis showed that covert HE and elevated blood NH3 were factors contributing to the development of overt HE. Electrolyte abnormalities and mild inflammation are involved in the pathogenesis of HE. Abnormal psychometric testing results and hyperammonemia are linked to subsequent development of overt HE.
本研究的目的是阐明心理测量测试结果、血氨（NH₃）水平、电解质异常和炎症程度之间的关系，以及它们与肝硬化（LC）患者显性肝性脑病（HE）发生的关联。在40例LC患者中，研究了隐匿性HE与血NH₃、钠（Na）和C反应蛋白（CRP）之间的关系。还研究了NH₃升高、低钠血症和CRP升高对显性HE发生的影响。隐匿性HE组的血清Na水平显著降低，血清CRP水平显著升高。在11个月的中位观察期内，10例患者发生了显性HE，多变量分析结果显示，隐匿性HE和血NH₃升高是导致显性HE发生的因素。电解质异常和轻度炎症参与了HE的发病机制。心理测量测试结果异常和高氨血症与随后显性HE的发生有关。
