肝硬化合并肝性脑病患者的脑血流动力学与认知功能
Cerebral Hemodynamics and Cognitive Function in Cirrhotic Patients with Hepatic Encephalopathy.
作者信息
Zhou Yuqing, Dong Qian, Zhang Rong, Zhou Shunfeng, Li Linqiang, Cheng Keran, Kong Rui, Yu Qiang, Xu Shizan, Li Jingjing, Li Sainan, Feng Jiao, Wu Liwei, Liu Tong, Lu Xiya, Chen Kan, Xia Yujing, Lu Jie, Zhou Yingqun, Guo Chuanyong
机构信息
Department of Gastroenterology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, China; The School of Medicine of Soochow University, Suzhou 215006, China.
The Shanghai Tenth Hospital, School of Clinical Medicine of Nanjing Medical University, Shanghai 200072, China.
出版信息
Gastroenterol Res Pract. 2016;2016:8485032. doi: 10.1155/2016/8485032. Epub 2016 Dec 21.
UNLABELLED
To investigate cerebral hemodynamics in cirrhotic patients with HE and to observe effects of treatment in cerebral hemodynamics and correlations among ammonia, cerebral hemodynamics, and cognitive function. . There were four groups: healthy controls (group 1), cirrhosis without HE (group 2), cirrhosis with MHE (group 3), and cirrhosis with OHE (group 4). Ammonia and cerebral hemodynamics (by TCD) were assessed. Patients in group 3 were subsequently randomized to two subgroups: the control (group A) and the treated (group B, treated with lactulose for two months), and they were retested for ammonia and TCD after treatment.
RESULTS
Ammonia, , , PI, and RI were statistically different before treatment, and ammonia, PI, and RI levels paralleled the severity of HE ( < 0.05). In group B, increased and ammonia, PI, and RI declined following treatment ( < 0.05), while there were no differences in group A ( > 0.05). Correlations were found between ammonia and , PI, RI, NCT-A, and DST and also found between , PI, RI, and NCT-A and DST ( < 0.05). . This study revealed that cerebral hemodynamics were related to the severity of HE and cerebral autoregulation was impaired. There were tight correlations among ammonia, cerebral hemodynamics, and cognitive function, and, following treatment, cerebral hemodynamics improved.
未标注
为研究肝硬化合并肝性脑病（HE）患者的脑血流动力学，观察治疗对脑血流动力学的影响以及氨、脑血流动力学和认知功能之间的相关性。研究分为四组：健康对照组（第1组）、无HE的肝硬化患者（第2组）、轻度肝性脑病（MHE）的肝硬化患者（第3组）和重度肝性脑病（OHE）的肝硬化患者（第4组）。评估氨水平和脑血流动力学（经颅多普勒超声，TCD）。第3组患者随后被随机分为两个亚组：对照组（A组）和治疗组（B组，用乳果糖治疗两个月），治疗后再次检测氨水平和TCD。
结果
治疗前，氨、 、 、搏动指数（PI）和阻力指数（RI）在统计学上存在差异，且氨、PI和RI水平与HE的严重程度平行（P<0.05）。B组治疗后 升高，氨、PI和RI下降（P<0.05），而A组无差异（P>0.05）。发现氨与 、PI、RI、数字连接试验A（NCT-A）和数字符号试验（DST）之间存在相关性， 、PI、RI与NCT-A和DST之间也存在相关性（P<0.05）。本研究表明，脑血流动力学与HE的严重程度相关，脑自动调节功能受损。氨、脑血流动力学和认知功能之间存在密切相关性，治疗后脑血流动力学得到改善。
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