国际流行病学传染病学杂志
國際流行病學傳染病學雜誌
국제류행병학전염병학잡지
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY AND INFECTIOUS DISEASE
2014年
2期
73-76
,共4页
周可幸%张思泉%刘华锋%韩加裕%颜成敏%赵曦
週可倖%張思泉%劉華鋒%韓加裕%顏成敏%趙晞
주가행%장사천%류화봉%한가유%안성민%조희
肝性脑病%脑氧利用率%肝硬化
肝性腦病%腦氧利用率%肝硬化
간성뇌병%뇌양이용솔%간경화
Hepatic encephalopathy%Cerebral oxygen utilization coefficients%Hepatic cirrhosis
目的 探讨肝硬化合并肝性脑病患者脑氧利用率(O2UCc)与病情预后的关系.方法 选择2012年6月至2013年8月在浙江中医药大学附属杭州西溪医院住院的肝硬化合并肝性脑病患者40例作为观察组,并随机选择同期住院肝硬化无肝性脑病患者40例作为对照组,通过颈内动脉和颈内静脉采血,检测颈内动脉血氧饱和度(SaO2)、颈内静脉血氧饱和度(SjO2);根据氧利用率的计算公式推导出O2UCc=S(a-j)O2/SaO2;分析O2UCc与肝性脑病病情及预后的关系.结果 观察组SjO2＞75％的患者有38例(95.0％).观察组SjO2高于对照组[(86.22±6.34)％∶(65.74±5.92)％],而O2UCc低于对照组[(13.13±4.84)％∶(32.72±6.67)],差异均有统计学意义(t=16.57,P＜0.05;t=26.76,P＜0.01).观察组中10例死亡患者与30例生存患者SaO2比较差异无统计学意义(P＞0.05),SjO2高于生存患者[(91.26±2.1 1)％∶(82.25±6.17)％],O2UCc均＜9.50％,低于生存患者[(7.57±2.01)％∶(15.76±5.04)％],且差异均有统计学意义(t=12.69、28.64,P＜0.05).结论 肝性脑病患者常伴脑氧代谢动力学障碍,以高SjO2和低O2UCc为主要表现,O2UCc＜9.5％可能提示预后不良.
目的 探討肝硬化閤併肝性腦病患者腦氧利用率(O2UCc)與病情預後的關繫.方法 選擇2012年6月至2013年8月在浙江中醫藥大學附屬杭州西溪醫院住院的肝硬化閤併肝性腦病患者40例作為觀察組,併隨機選擇同期住院肝硬化無肝性腦病患者40例作為對照組,通過頸內動脈和頸內靜脈採血,檢測頸內動脈血氧飽和度(SaO2)、頸內靜脈血氧飽和度(SjO2);根據氧利用率的計算公式推導齣O2UCc=S(a-j)O2/SaO2;分析O2UCc與肝性腦病病情及預後的關繫.結果 觀察組SjO2＞75％的患者有38例(95.0％).觀察組SjO2高于對照組[(86.22±6.34)％∶(65.74±5.92)％],而O2UCc低于對照組[(13.13±4.84)％∶(32.72±6.67)],差異均有統計學意義(t=16.57,P＜0.05;t=26.76,P＜0.01).觀察組中10例死亡患者與30例生存患者SaO2比較差異無統計學意義(P＞0.05),SjO2高于生存患者[(91.26±2.1 1)％∶(82.25±6.17)％],O2UCc均＜9.50％,低于生存患者[(7.57±2.01)％∶(15.76±5.04)％],且差異均有統計學意義(t=12.69、28.64,P＜0.05).結論 肝性腦病患者常伴腦氧代謝動力學障礙,以高SjO2和低O2UCc為主要錶現,O2UCc＜9.5％可能提示預後不良.
목적 탐토간경화합병간성뇌병환자뇌양이용솔(O2UCc)여병정예후적관계.방법 선택2012년6월지2013년8월재절강중의약대학부속항주서계의원주원적간경화합병간성뇌병환자40례작위관찰조,병수궤선택동기주원간경화무간성뇌병환자40례작위대조조,통과경내동맥화경내정맥채혈,검측경내동맥혈양포화도(SaO2)、경내정맥혈양포화도(SjO2);근거양이용솔적계산공식추도출O2UCc=S(a-j)O2/SaO2;분석O2UCc여간성뇌병병정급예후적관계.결과 관찰조SjO2＞75％적환자유38례(95.0％).관찰조SjO2고우대조조[(86.22±6.34)％∶(65.74±5.92)％],이O2UCc저우대조조[(13.13±4.84)％∶(32.72±6.67)],차이균유통계학의의(t=16.57,P＜0.05;t=26.76,P＜0.01).관찰조중10례사망환자여30례생존환자SaO2비교차이무통계학의의(P＞0.05),SjO2고우생존환자[(91.26±2.1 1)％∶(82.25±6.17)％],O2UCc균＜9.50％,저우생존환자[(7.57±2.01)％∶(15.76±5.04)％],차차이균유통계학의의(t=12.69、28.64,P＜0.05).결론 간성뇌병환자상반뇌양대사동역학장애,이고SjO2화저O2UCc위주요표현,O2UCc＜9.5％가능제시예후불량.
Objective To study the relationship between cerebral oxygen utilization coefficients (O2UCc) in hepatic cirrhosis patients with hepatic encephalopathy (HE) and prognosis.Methods Case group included 40 hepatic cirrhosis patients accompanied by HE who were treated in Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University from June 2012 to August 2013,and control group included 40 hepatic cirrhosis patients without HE treated in the same hospital during the same period.The changes in oxygen saturation of carotid blood (SaO2) and oxygen saturation of jugular blood (SjO2) were detected by blood gas analysis,and then O2UCc was calculated [O2UCc=S (a-j)O2/SaO2].The relationship of the patients' condition and prognosis was analyzed.Results Thirty-eight patients with SjO2 higher than 75％ accounted for 95.0％ in cases group.SjO2 was significantly higher and O2UCc was significantly lower in case group than those in control group[(86.22±6.34)％ vs (65.74±5.92)％,t=16.57,P＜0.05 ; (13.13±4.84)％ vs (32.72±6.67)％,t=26.76,P＜0.0 1].In case group,no significant difference in SaO2 was noted between 10 dead cases and 30 alive patients (P＞0.05); SjO2 was significantly higher and O2UCc was obviously lower in dead patients compared with those in alive ones [(91.26±2.11)％ vs (82.25± 6.17)％,(7.57±2.01)％ vs (15.76±5.04)％,t=12.69,28.64,P＜0.05]; O2UCc were all lower than 9.5％ in 10 dead cases.Conclusions Patients with hepatic encephalopathy often encounter with obstacles in the dynamics of cerebral oxidative metabolism,the main manifestation of which are high SjO2 and low O2UCc.O2UCc lower than 9.5％ may suggest a bad prognosis.
