Analysis Of Common Risk Factors For Secondary Hepatic Encephalopathy In Patients With Cirrhosis And Observation Of Electroencephalographic Features Of Minimal Hepatic Encephalopathy

Objective: To analyze the common risk factors for secondary hepatic encephalopathy in patients with cirrhosis.To observe the characteristics of EEG in patients with cirrhosis secondary to minimal hepatic encephalopathy,and to provide scientific facts and theoretical basis for the early non-invasive diagnosis of minimal hepatic encephalopathy and the clinical application of EEG in mild hepatic encephalopathy.Methods:(1)A total of 260 patients with cirrhosis hospitalized in the Third Xiangya Hospital of Central South University were retrospectively collected,and patients were divided into 2 groups according to whether they had secondary hepatic encephalopathy.The common risk factors for hepatic encephalopathy in cirrhosis were then discussed based on the general clinical data of the included patients.(2)The prospective study included 12 patients with cirrhosis in the Department of Infection of the Third Xiangya Hospital of Central South University,perfected psychological test scores and EEG examinations,divided the patients into the group with minimal hepatic encephalopathy and the group without minimal hepatic encephalopathy according to the psychological test results,compared the differences in the total mean power spectrum of the whole brain in different frequency bands and the power spectrum of different brain regions in different frequency bands of EEG between the two groups,and explored the EEG characteristics of patients with minimal hepatic encephalopathy in cirrhosis.Results:(1)The results of univariate analysis showed that MELD score,INR,PTA,K,Alb,Tb,N,Hb,WBC and the use of PPIs may be associated with secondary HE in patients with cirrhosis.(2)The results of multifactorial analysis showed that MELD score,N,Hb,WBC,and use of PPIs may be associated with secondary HE in patients with cirrhosis.(3)Patients with cirrhosis whose power spectrum in the alpha band is suppressed may be more prone to secondary minimal hepatic encephalopathy.Conclusion:(1)MELD score,white blood cell count,absolute neutrophil value,hemoglobin,and use of proton pump inhibitors may have correlation with secondary hepatic encephalopathy in patients with cirrhosis.Among them,MELD score,white blood cell count,and use of proton pump inhibitors are risk factors associated with secondary HE in patients with cirrhosis,and absolute neutrophil value and hemoglobin are protective factors associated with secondary HE in patients with cirrhosis.(2)EEG is a non-invasive test with mature clinical technique,which can reflect the brain activity of patients with mild hepatic encephalopathy to a certain extent,and is useful for early prediction of secondary mild hepatic encephalopathy in patients with cirrhosis,in which the power spectrum of alpha band is suppressed for the diagnosis of mild hepatic encephalopathy.