肝性脊髓病的病因、临床特征以及预后转归

摘要/Abstract

摘要： 目的探讨肝性脊髓病(hepatic myelopathy, HM)的病因、临床特征以及预后转归。方法选取2016年4月—2022年5月期间包头市蒙医中医医院诊治肝硬化患者49例,根据是否存在肝性脊髓病分为HM组(n=24)和非HM组(n=25),HM组患者根据预后情况分为好转组(n=6)和非好转组(n=18)。分析HM患者和非HM患者病因,比较好转组和非好转组患者临床资料。结果 HM患者和非HM患者病因差异无统计学意义,乙型肝炎为肝性脊髓病最常见的病因(54.2%)。好转组患者CHE水平和Child-Pugh分级B级比例分别为(3597.7±1194.5)U/L和83.3%,显著高于非好转组[(1953.8±863.4)U/L和22.2%]。结论乙型肝炎为肝性脊髓病最常见的病因,肌力下降是肝性脊髓病患者最常见的临床表现,CHE水平和Child-Pugh分级可反映患者的预后情况。

关键词: 肝性脊髓病, 病因, 预后

Abstract: Objective To explore the etiology, clinical features and prognosis of hepatic myelopathy (HM). Methods Forty-nine patients with liver cirrhosis admitted to Baotou Mongolian Traditional Chinese Medicine Hospital between April 2016 and May 2022 were divided into HM group (n=24) and non-HM group (n=25) according to the presence of HM. HM group was divided into improvement group (n=6) and non-improvement group (n=18) according to prognosis. The etiologies of HM patients and non-HM patients were compared and the clinical data of improvement group and non-improvement group were compared. Methods There was no significant difference when comparing the etiology of HM patients with that of non-HM patients. Hepatitis B was the most common cause of HM (54.2%). Comparing the clinical data of the patients in the improvement group and the non-improvement group, the CHE level and the proportion of Child-Pugh grade B in the improvement group were (3597.7±1194.5) U/L and 83.3% respectively, which were significantly higher than that of non-improvement group [(1953.8±863.4) U/L and 22.2%]. Conclusion Hepatitis B is the most common cause of HM, and decreased muscle strength is the most common clinical manifestation in patients with hepatic myelopathy. CHE level and Child-Pugh grade may reflect the prognosis of patients.

Key words: Hepatic myelopathy, Etiology, Prognosis

苏德巴彦尔·苏布达, 吴喜德, 乌敦高娃. 肝性脊髓病的病因、临床特征以及预后转归[J]. 肝脏, 2025, 30(1): 74-77.

Sudbayan er Subuda, WU Xi-de, Udungova. Analysis of etiology, clinical features and prognosis of hepatic myelopathy[J]. Chinese Hepatolgy, 2025, 30(1): 74-77.

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