肝硬化患者发生肝性脑病危险因素的Meta分析

承德医学院学报 ›› 2022, Vol. 39 ›› Issue (4): 302-307.

肝硬化患者发生肝性脑病危险因素的Meta分析

孟书静, 张强, 苏醒, 范炯同, 成帅, 秦殿菊^*

承德医学院护理学院,河北承德 067000

收稿日期:2021-06-21 出版日期:2022-08-10 发布日期:2022-10-25
通讯作者: *

Meta-analysis of Risk Factors for Hepatic Encephalopathy in Patients with Cirrhosis

MENG Shu-jing, ZHANG Qiang, SU Xing, FAN Jiong-tong, CHENG Shuai, QIN Dian-ju^*

School of Nursing, Chengde Medical University, Chengde, Hebei, 067000, China

Received:2021-06-21 Online:2022-08-10 Published:2022-10-25

摘要/Abstract

摘要： 目的系统评价肝硬化患者发生肝性脑病的危险因素。方法检索国内外数据库,搜集有关肝硬化患者发生肝性脑病危险因素的病例对照研究,检索时限均从建库~2020年12月31日。完成文献筛选和质量评价后应用Revman5.4软件进行meta分析。结果本研究共纳入文献9篇,1569例患者,涉及10项危险因素,其中血清白蛋白和血肌酐异质性较高未进行meta分析。血氨、感染、上消化道出血、腹水、血清总胆红素、凝血酶原时间、血尿素氮、血钠是肝硬化患者发生肝性脑病的危险因素(P<0.05)。结论血氨水平升高、感染、上消化道出血、腹水、血清总胆红素水平增高、凝血酶原时间延长、血钠水平下降和血尿素氮升高是肝硬化患者发生肝性脑病的危险因素,血清白蛋白水平和血肌酐水平不确定。

关键词: 肝硬化, 肝性脑病, Meta分析。

Abstract: Objective To evaluate the risk factors of hepatic encephalopathy in patients with cirrhosis. Methods Retrieve database both at home and abroad, collecting the relevant risk factors in patients with cirrhosis of the liver encephalopathy of case-control study, retrieval time limit are built from library to December 31, 2020, after finishing the document screening and quality evaluation software application Revman5.4 meta-analysis. Results A total of 9 papers with 1569 patients were included in this study, involving 10 risk factors, of which high heterogeneity in serum albumin and blood creatinine was not subjected to Meta-analysis.Serum ammonia, infection, upper gastrointestinal hemorrhage, ascites, serum total bilirubin, prothrombin time, urea nitrogen and serum natrium are risk factors for hepatic encephalopathy in patients with cirrhosis (P<0.05). Conclusion Elevated serum ammonia level, infected, upper gastrointestinal bleeding, ascites, serum total bilirubin level increased, prothrombin time prolonged, serum sodium level decreased and blood urea nitrogen increased are risk factors for hepatic encephalopathy in patients with cirrhosis, serum albumin levels and serum creatinine levels were uncertain.

Key words: liver cirrhosis, hepatic encephalopathy, meta-analysis

中图分类号:

R575.2

孟书静, 张强, 苏醒, 范炯同, 成帅, 秦殿菊. 肝硬化患者发生肝性脑病危险因素的Meta分析[J]. 承德医学院学报, 2022, 39(4): 302-307.

MENG Shu-jing, ZHANG Qiang, SU Xing, FAN Jiong-tong, CHENG Shuai, QIN Dian-ju. Meta-analysis of Risk Factors for Hepatic Encephalopathy in Patients with Cirrhosis[J]. Journal of Chengde Medical University, 2022, 39(4): 302-307.

参考文献

[1] Romero-Gómez M, Boza F, García-Valdecasas MS, et al.Subclinical hepatic encephalopathy predicts the development of overt hepatic encephalopathy[J]. Am J Gastroenterol, 2001, 96(9): 2718-2723.
[2] Stang A.Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses[J]. European Journal of Epidemiology, 2010, 25(9): 603-605.
[3] Duah A, Agyei-Nkansah A, Osei-Poku F, et al.The Prevalence, Predictors, and In-Hospital Mortality of Hepatic Encephalopathy in Patients with Liver Cirrhosis Admitted at St. Dominic Hospital in Akwatia, Ghana[J]. Canadian Journal of Gastroenterology and Hepatology, 2020, (3): 1-8.
[4] Bale A, Pai CG, Shetty S, et al.Prevalence of and Factors Associated with Minimal Hepatic Encephalopathy in Patients with Cirrhosis of Liver[J]. Journal of Clinical and Experimental Hepatoligy, 2018, 8(2): 156-161.
[5] 鞠莹,宋薇,孟晨鑫,等. 44例肝炎后肝硬化肝性脑病的危险因素分析[J]. 中国医师杂志,2006,(7):974-975.
[6] 陈晓锋,李秋元. 肝硬化并发肝性脑病的危险因素及预后分析[J]. 临床医学工程,2017,24(5):649-650.
[7] 张小军,郭艳,朱祈锋. 肝硬化并发肝性脑病的危险因素与预后相关因素分析[J]. 中国实用神经疾病杂志,2016,19(9):71-73.
[8] 林志鹏,郭如意. 乙型肝炎后肝硬化合并肝性脑病的危险因素分析[J]. 中国基层医药,2014,21(1):65-67.
[9] 姚毓洲,张耿坤,翁钦杰. 肝硬化并发肝性脑病的预后相关因素分析[J]. 哈尔滨医药,2019,39(2):103-104.
[10] 张鸣,段志军. 乙肝后肝硬化合并肝性脑病的影响因素[J]. 世界华人消化杂志,2012,20(13):1148-1155.
[11] 张斌. 乙型肝炎后肝硬化合并肝性脑病的影响因素分析[J]. 检验医学与临床,2013,10(22):3039-3040.
[12] 王娜,李娟,李霞,等. 肝硬化患者肝性脑病发生风险的回顾性研究[J]. 第三军医大学学报,2019,41(9):885-890.
[13] Maqsood S, Saleem A, Iqbal A, et al.Precipitating factors of hepatic encephalopathy: Experience at Pakistan Institute of Medical Sciences Islamabad[J]. Journal of Ayub Medical College Abbottabad Jamc, 2006, 18(4): 58.
[14] Iwasa M, Takei Y.Pathophysiology and management of hepatic encephalopathy 2014 update: Ammonia toxicity and hyponatremia[J]. Hepatology Research the Official Journal of the Japan Society of Hepatology, 2016, 45(12): 1155-1162.
[15] Bossen L, Ginès P, Vilstrup H, et al.Serum sodium as a risk factor for hepatic encephalopathy in patients with cirrhosis and ascites[J]. Journal of Gastroenterology and Hepatology, 2019, 34(5): 914-920.