肝硬化患者腹水及总淋巴细胞计数与肝性脑病发生的相关性研究

Ratna Adelia Pravitasari
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引用次数: 0

摘要

肝性脑病(HE)是一种表现为广泛的神经精神异常的脑功能障碍,由肝功能不全或门静脉高压引起的门静脉系统分流引起。肝硬化门静脉高压也可引起腹水,为最常见的临床表现。此外,免疫功能障碍,其中之一是总淋巴细胞计数(TLC)减少,发生在肝硬化,引发全身炎症反应。这种全身炎症反应在HE中起作用。本研究的目的是了解肝硬化患者腹水和TLC与HE发生的关系。本研究采用回顾性队列设计,在赛弗安华医院进行。本研究样本量的确定采用总抽样法。肝性脑病的诊断基于West Haven标准。腹水由体格检查和/或腹部超声检查确定。总淋巴细胞计数来源于病历,全血细胞计数采用XS-800i血液学分析仪检测。数据分析采用logistic回归检验,p<0.05为显著性,置信区间(CI) 95%。采用回顾性队列法观察78例肝硬化患者HE发生情况,并进行腹水体检和实验室检查。腹水与HE相关性的统计分析结果具有显著性,比值比为5.108,CI为1.36 ~ 19.25。另一方面,TLC与HE的发生无显著相关性。根据分析结果,腹水与HE有相关性,而TLC与HE无相关性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Correlation between Ascites and Total Lymphocyte Count with Occurrence of Hepatic Encephalopathy in Liver Cirrhosis Patients
Hepatic encephalopathy (HE) is brain dysfunction manifested as a broad spectrum of neuropsychiatric abnormalities caused by hepatic insufficiency or portosystemic shunting due to portal hypertension. Portal hypertension in liver cirrhosis also causes ascites, as the most common clinical manifestation. Further, immune dysfunction, one of which is decreased total lymphocyte count (TLC), happens at liver cirrhosis, which triggers the systemic inflammatory response. This systemic inflammatory response plays a role in HE. Objective of this study is to know the correlation between ascites and TLC with occurence of HE in liver cirrhosis patient. This study was conducted by retrospective cohort design in Saiful Anwar Hospital. Determination of sample amount at this study used total sampling method. Hepatic encephalopathy diagnosis was based on West Haven Criteria. Ascites was determined by physical examination and/or abdominal ultasonography. Total lymphocyte count data was taken from medical record, with complete blood count examination used XS-800i hematology analyzer machine. Data were analyzed using a logistic regression test, with p<0.05 was considered significant and Confidence Interval (CI) 95%. Seventy-eight liver cirrhosis patients were observed using a retrospective cohort method regarding the HE occurrence, and physical examination for ascites and laboratory examination were performed. The statistical analysis result of the correlation between ascites and HE is significant with an odds ratio of 5.108 and CI of 1.36-19.25. On the other hand, TLC has no significant correlation with the occurrence of HE. Based on this analysis result, it is concluded that ascites has a correlation with HE, but TLC does not. 
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