A Clinical Analysis Of 378 Cases Of Prognostic Factors In Hepatic Encephalopathy With Logistic

Object: To analyze and explore the prognostic factors for patients with hepatic encephalopathy. Methods: 378 patients with hepatic encephalopathy admitted in The First Affiliated Hospital of Xinjiang Medical University between January 2000 to July 2009 were enrolled in this study. The patients were divided into improved group and deteriorated group according to therapy. The clinical date were analyzed by using chi square test, independent-Samples T Test and Binary logistic regression. Result: For total patients ,the mortality rate was 66.14% 260 males ( 68.78% ) and 118 females(31.22%).Average age was 52.52±14.57ys, the majority lied in > 45ys(254 patients), 105 were severe virus hepatitis(27.78%), 152 were cirrhosis(40.21%), 45 were cirrhosis with severe virus hepatitis(11.90%);76 hepatocellular carcinoma(20.11%); There were 250 in hepatitis B virus infection, 263 in cirrhosis ,including 189 in hepatitis cirrhosis.There were 28 in grade A(7.41%) , 90 in B (23.81%) , 260 in C (68.78%)according to the Child-Pugh classification and the effective reduced significantly as the grade ascending.The grade of HE wasⅠin 41 (10.85%) patients,Ⅱin 98(25.93%),Ⅲin 88 (23.28%)andⅣin 151 (39.95%),also the effective reduced with the accordance of grade lifted up significantly. the MELD score: <20:26 patients, 20-30:66 patients,40-30:78 patients,>40:200 patients. also the effective reduced with the accordance of score lifted up significantly.univariate analysis showed that there was no significant difference in the prognosis between improved group and deteriorated group in nationality,sex,high ammonia,albumin or age,ammonia reduced,constipation / diarrhoea (P>0.05). HE were more common seen in infection(the major of SBP),The factors that significantly affected the prognosis of hepatic encephalopathy include The grade of HE,Hyponatremias,infection, Hepatorenal syndrome,PH,PTA,the foundation disease with the multi-variate analysis. The high stage of HE,the level of PTA,PH,INR,TBIL,Cr,Hyponatremias,severe virus hepatitis,the number of complications ,the worse prognosis and the high mortality.At presently, there is not valid method for hepatic encephalopathy, avoiding aggravating liver injury, prevention and removal of complications are the key managements.Conclusion :HE were more common seen in male and its peak age lied in the middle-aged and the elderly ,the major etiology of HE was all kinds of liver cirrhosis. HBV infection was the major cause of HE.The grade of HE,Hyponatremias,infection, Hepatorenal syndrome,PH,the MELD score,severe virus hepatitis,the prothrombin time activity(PTA),INR,total bilirubin(TBil),creatinine(Cr)were counted in for predicting the outcome of HE.