Abstract: Objective To analyze clinical features of hepatitis B patients with decompensated cirrhosis combined with hepatic myelopathy. Methods Between April 2018 and April 2023, 40 hepatitis B patients with decompensated cirrhosis and hepatic myelopathy were enrolled in this study as the observation group. A control group consisting of 55 hepatitis B patients with decompensated cirrhosis but without hepatic myelopathy was also selected from the same period. Clinical characteristics of both groups were compared, and independent risk factors for hepatic myelopathy in patients with decompensated cirrhosis were analyzed using multifactorial logistic regression. Results The levels of total bilirubin, glutathione, glutathione and serum ammonia in the observation group were (40.5±24.8) μmol/L, (220.6±57.8) U/L, (253.5±66.4) U/L, (116.3±23.5) μmol/L, respectively, which were higher than those in the control group [(32.6±15.4) μmol/L, (120.5±58.2) U/L, (153.1±64.6) U/L, (72.6±13.8) μmol/L]. Conversely, albumin, cholinesterase, and prothrombin time activity in the observation group were (10.3±2.1) g/L, (2.1±0.8) U/L, and (27.8±4.2) %, respectively, which were significantly lower than those in the control group [(12.1± (2.2) g/L, (2.6±0.2) U/L, (31.6±6.8) %, respectively, P<0.05]. Multifactorial logistic regression analysis identified alanine aminotransferase, prothrombin time activity, high serum ammonia, and low albumin as independent risk factors for hepatic myelopathy in hepatitis B patients with decompensated cirrhosis (OR=0.382, 4.568, 4.166, 0.401, P<0.05). Conclusion Albumin transaminase, prothrombin time activity, high blood ammonia, and low albumin are independent risk factors for hepatic myelopathy in patients with decompensated cirrhosis due to hepatitis B.

Key words: Hepatitis B, Decompensated cirrhosis, Hepatic myelopathy, Clinical features