Abstract：
Muscle alterations, portosystemic shunts (SPSS) and minimal hepatic encephalopathy (MHE) are related to hepatic encephalopathy (HE), however no studies have investigated the relative role of all these risk factors detected in the same patients. The aim of the study was to assess the prognostic impact of muscle alterations, MHE and SPSS on hepatic encephalopathy and transplant free survival.
114 cirrhotics were submitted to Psychometric Hepatic Encephalopathy Score (PHES) and Animal Naming Test (ANT) to detect MHE. CT scan was used to analyze the skeletal muscle index (SMI), muscle attenuation and SPSS. The incidence of the first episode of HE and survival were estimated.
Previous HE was present in 47 patients (41%). The variables independently associated to previous HE were: sarcopenia, MHE and SPSS. 44 patients (39%) developed overt HE during 14±11 months; MHE and SPSS were the only variables significantly asociated to overt HE. During the same follow-up, 42 patients died (37%); MELD and sarcopenia were the only variables significantly asociated to transplant free survival.
MHE, sarcopenia and SPSS are clinically relevant and should be sought for in cirrhotics. In particular, MHE and SPSS are the only risk factors significantly associated to the development of HE while MELD and sarcopenia are independently associated to overall mortality.
114 cirrhotics were submitted to Psychometric Hepatic Encephalopathy Score (PHES) and Animal Naming Test (ANT) to detect MHE. CT scan was used to analyze the skeletal muscle index (SMI), muscle attenuation and SPSS. The incidence of the first episode of HE and survival were estimated.
Previous HE was present in 47 patients (41%). The variables independently associated to previous HE were: sarcopenia, MHE and SPSS. 44 patients (39%) developed overt HE during 14±11 months; MHE and SPSS were the only variables significantly asociated to overt HE. During the same follow-up, 42 patients died (37%); MELD and sarcopenia were the only variables significantly asociated to transplant free survival.
MHE, sarcopenia and SPSS are clinically relevant and should be sought for in cirrhotics. In particular, MHE and SPSS are the only risk factors significantly associated to the development of HE while MELD and sarcopenia are independently associated to overall mortality.
摘要：
肌肉改变,门体分流（SPSS）和轻微肝性脑病（MHE）与肝性脑病（HE）有关，然而，没有研究调查在同一患者中检测到的所有这些危险因素的相对作用。该研究的目的是评估肌肉改变对预后的影响，MHE和SPSS对肝性脑病和无移植生存率的影响。
114例肝硬化患者接受心理测量肝性脑病评分（PHES）和动物命名试验（ANT）检测MHE。CT扫描用于分析骨骼肌指数（SMI），肌肉衰减和SPSS。估计了第一次HE发作的发生率和生存率。
47例患者（41%）存在既往HE。与先前HE独立相关的变量是：肌少症，MHE和SPSS。44例患者（39％）在14±11个月内发生了明显的HE；MHE和SPSS是唯一与明显HE相关的变量。在同样的后续行动中，42例患者死亡（37％）；MELD和肌肉减少症是唯一与无移植生存显着相关的变量。
MHE,肌少症和SPSS是临床相关的，应在肝硬化中寻求。特别是,MHE和SPSS是与HE发展显著相关的唯一危险因素,而MELD和少肌症与总死亡率独立相关。
114例肝硬化患者接受心理测量肝性脑病评分（PHES）和动物命名试验（ANT）检测MHE。CT扫描用于分析骨骼肌指数（SMI），肌肉衰减和SPSS。估计了第一次HE发作的发生率和生存率。
47例患者（41%）存在既往HE。与先前HE独立相关的变量是：肌少症，MHE和SPSS。44例患者（39％）在14±11个月内发生了明显的HE；MHE和SPSS是唯一与明显HE相关的变量。在同样的后续行动中，42例患者死亡（37％）；MELD和肌肉减少症是唯一与无移植生存显着相关的变量。
MHE,肌少症和SPSS是临床相关的，应在肝硬化中寻求。特别是,MHE和SPSS是与HE发展显著相关的唯一危险因素,而MELD和少肌症与总死亡率独立相关。
