Factors and prognostic evaluation of covert hepatic encephalopathy in patients with hepatitis B-related cirrhosis

Abstract

Abstract: Objective To explore factors and prognosis of hepatitis B cirrhosis patients complicated with covert hepatic encephalopathy (CHE), and to provide theoretical basis for clinical diagnosis and prognosis improvement of hepatitis B cirrhosis complicated with covert CHE. Methods Between May 2020 and June 2022, 134 patients with hepatitis B cirrhosis were divided into CHE group (n=69) and non-CHE group (n=65). According to the progression of CHE during follow-up, the CHE group was further divided into hepatic encephalopathy (HE) group (n=18) and non-HE group (n=51) . The clinical data and prognosis were compared between CHE and non-CHE groups, and logistic regression analysis was used to analyze the risk factors of CHE patients. Results Comparing the clinical data of CHE group and non-CHE group, age, the proportion of HE, decompensated liver cirrhosis, hepatorenal syndrome, complicated infection, the MELD score and the proportion of liver function class C in CHE group were (58.3±13.1)、37.7%、98.6%、5.8%、50.7%、(10.5±4.6) and 17.4%, respectively, which were significantly higher than those in the non-CHE group [(51.9±12.9)、4.6%、53.8%、1.5%、24.6%、(7.2±2.5) and 1.5% (P<0.05)]. According to logistic regression analysis, age, MELD score, HE history and liver function grade were independent risk factors of CHE. The proportion of grade C of liver function, the proportion of HE history and MELD score in HE patients were 50.0%、61.1% and (14.7±6.3), respectively, which were significantly higher than those in the non-HE group [5.9%、29.4% and (9.5±4.2) (P<0.05)]. Conclusion Patients with hepatitis B cirrhosis complicated with CHE were affected by age, HE history, infection and other factors. Their prognosis were related to liver function grade, HE history and MELD score. Greater clinical attention should be focused on these risk factors to prevent the occurrence of CHE and improve the patients prognosis.

Key words: Hepatitis B, Liver cirrhosis, Covert hepatic encephalopathy

WANG Li-hui, LIU Shuang-ping, LU Qiu-yan, SHEN Pei-gen, XU Cheng-run. Factors and prognostic evaluation of covert hepatic encephalopathy in patients with hepatitis B-related cirrhosis[J]. Chinese Hepatolgy, 2024, 29(7): 817-820.

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