Influencing factors for death within 30 days in patients with decompensated hepatitis B cirrhosis and hepatic encephalopathy / 临床肝胆病杂志

ObjectiveTo investigate the influencing factors for death within 30 days in patients with decompensated hepatitis B cirrhosis and hepatic encephalopathy. MethodsA retrospective analysis was performed for 616 patients with hepatitis B cirrhosis and hepatic encephalopathy in Beijing Ditan Hospital from January 2008 to April 2018， and all patients were followed up for 30 days. According to their prognosis， they were divided into survival group with 488 patients and death group with 128 patients. The Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. The Cox regression analysis was used to investigate the independent risk factors for death within 30 days in patients with hepatitis B cirrhosis and hepatic encephalopathy. ResultsThe multivariate Cox regression analysis showed that age （hazard ratio ［HR］=1.029， 95% confidence interval ［CI］： 1.014‍ — ‍1.044， P<0.001）， Model for End-Stage Liver Disease （MELD） score （HR=1.118， 95%CI： 1.098‍ — ‍1.139， P<0.001）， and neutrophil-to-lymphocyte ratio （NLR） （HR=1.036， 95%CI： 1.015‍ — ‍1.057， P=0.001） were independent risk factors for death within 30 days in patients with hepatitis B cirrhosis and hepatic encephalopathy. The stratified analysis showed that the patients with a MELD score of≥20 and an NLR of≥4 had a higher risk of death， with a 30-day mortality rate of 57.1% （80/140）. The patients with a MELD score of<20 and an NLR of<4 had a 30-day mortality rate of 3.9% （9/232）. ConclusionAge， MELD score， and NLR are independent risk factors for death within 30 days in patients with hepatitis B cirrhosis and hepatic encephalopathy， and patients with a MELD score of≥20 and an NLR of≥4 tend to have a high risk of death.

Association of intestinal microecology with hepatic encephalopathy / 临床肝胆病杂志

Hepatic encephalopathy (HE) is a common and complex neuropsychiatric complication in patients with liver cirrhosis and has the features of high incidence, recurrence, and mortality rates, and it is also an important factor for the increased risk of hospitalization and rehospitalization. At present, there are still no effective drugs for HE. Recent studies have found that intestinal microecological changes are associated with the development, progression, and prognosis of HE, and the regulation of intestinal flora has a certain preventive effect on HE. This article summarizes the research on the association between intestinal microecology and HE in recent years and hopes to provide new ideas for clinical prevention and treatment of HE.