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轻微肝性脑病和鳖甲软肝方与非酒精性肝硬化患者首次医院再入院有关。

Minimal Hepatic Encephalopathy and Biejia-Ruangan Are Associated with First Hospital Readmission in Nonalcoholic Cirrhosis Patients.

作者信息

Jiang Ting-Ting, Liu Xiao-Li, Jiang Yu-Yong, Wang Xian-Bo, Yang Zhi-Yun

机构信息

Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.

出版信息

Evid Based Complement Alternat Med. 2021 May 7;2021:6652858. doi: 10.1155/2021/6652858. eCollection 2021.

Abstract

. Patients with cirrhosis are often hospitalized repeatedly for a variety of complications. This retrospective study aimed to assess the effects of minimal hepatic encephalopathy (MHE) and Biejia-Ruangan (BR) on first hospital readmission in nonalcoholic cirrhosis patients without previous overt hepatic encephalopathy (OHE) or hepatocellular carcinoma (HCC). . A total of 176 hospitalized patients with nonalcoholic cirrhosis were included in this retrospective study. Patients who were first admitted to Beijing Ditan Hospital of Capital Medical University from January 2017 to September 2019 were enrolled. The primary endpoint was their first liver-related hospital readmission. The risk factors for readmission were analyzed by Cox proportional hazard regression analysis. . A total of 176 nonalcoholic cirrhosis patients without previous OHE or HCC were included; 57 patients (32.4%) were diagnosed with MHE, and 63 patients (35.8%) were administered BR (2 g, three times a day). Multivariate analysis revealed that nonalcoholic cirrhosis patients with MHE (HR, 5.805; 95% CI, 3.007-11.206; , < 0.001) and a higher Model for End-Stage Liver Disease (MELD) score (HR, 1.145; 95% CI, 1.068-1.227; < 0.001) had an increased risk of first hospital readmission, and patients treated with BR (HR, 0.318; 95% CI, 0.151-0.670; =0.003) had a decreased risk of first hospital readmission. . MHE increased the risk of hospital readmission in nonalcoholic cirrhosis patients without previous OHE or HCC, and this risk was decreased by BR administration.

摘要

肝硬化患者常因各种并发症反复住院。这项回顾性研究旨在评估轻微肝性脑病(MHE)和鳖甲软肝(BR)对既往无明显肝性脑病(OHE)或肝细胞癌(HCC)的非酒精性肝硬化患者首次再入院的影响。

本回顾性研究共纳入176例住院的非酒精性肝硬化患者。纳入2017年1月至2019年9月首次入住首都医科大学附属北京地坛医院的患者。主要终点是他们首次因肝脏相关疾病再入院。通过Cox比例风险回归分析来分析再入院的危险因素。

共纳入176例既往无OHE或HCC的非酒精性肝硬化患者;57例(32.4%)被诊断为MHE,63例(35.8%)接受BR治疗(2克,每日三次)。多因素分析显示,患有MHE的非酒精性肝硬化患者(风险比[HR],5.805;95%置信区间[CI],3.007 - 11.206;P < 0.001)和终末期肝病模型(MELD)评分较高(HR,1.145;95% CI,1.068 - 1.227;P < 0.001)的患者首次再入院风险增加,而接受BR治疗的患者(HR,0.318;95% CI,0.151 - 0.670;P = 0.003)首次再入院风险降低。

MHE增加了既往无OHE或HCC的非酒精性肝硬化患者的再入院风险,而BR给药可降低这种风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/29aa/8123979/cbc0627c6908/ECAM2021-6652858.001.jpg

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