Saibara T, Maeda T, Onishi S, Yamamoto Y
1st Department of Medicine, Kochi Medical School, Nankoku, Japan.
Electroencephalogr Clin Neurophysiol. 1993 May;86(5):329-34. doi: 10.1016/0013-4694(93)90045-w.
In 19 acute hepatitis patients with severe coagulopathy who were fully alert and oriented without any changes of mood or behavior, the P300 latency and the arterial blood ketone body ratio (KBR) were assessed as predictors of fulminant hepatitis. All 5 patients developing fulminant hepatitis had a corrected P300 latency longer than 345 msec and 4 of them had a KBR below 0.6. There was a significant negative correlation between the KBR and the blood ammonia level and between the KBR and the corrected P300 latency, while there was a positive correlation between the blood ammonia level and the corrected P300 latency. These data suggest that hepatic encephalopathy develops when loss of hepatic detoxifying activity allows toxic substances to reach the brain and induce cerebral edema. Our findings also suggest the clinical value of using the P300 latency combined with the KBR as predictors of fulminant hepatitis.
在19例患有严重凝血障碍的急性肝炎患者中，这些患者神志完全清醒且定向力正常，情绪和行为无任何改变，对其P300潜伏期和动脉血酮体比率（KBR）进行评估，作为暴发性肝炎的预测指标。所有5例发展为暴发性肝炎的患者校正P300潜伏期均超过345毫秒，其中4例KBR低于0.6。KBR与血氨水平之间以及KBR与校正P300潜伏期之间存在显著负相关，而血氨水平与校正P300潜伏期之间存在正相关。这些数据表明，当肝脏解毒活性丧失使有毒物质到达大脑并诱发脑水肿时，肝性脑病就会发生。我们的研究结果还表明，将P300潜伏期与KBR结合作为暴发性肝炎预测指标具有临床价值。
