Peculiarities of Hepatic Encephalopathy in Patients with Alcohol Liver Cirrhosis Against the Background of Chronic Bronchitis Exacerbation

I. Kobitovych, N. Virstiuk, L. Losiuk, V. Vovchuk, H. Markiv

Abstract


Objective. To evaluate the clinical manifestations of hepatic encephalopathy (HE) in patients with alcohol liver cirrhosis (ALC) in exacerbation of chronic bronchitis (CB).

Materials and methods. 100 patients with ALC class B and C according to Child-Pugh, 82.00% of men and 18.00% of women aged (47.2±3.9) years, were examined: 48 patients without combination with CB (group I); 52 patients on the background of CB exacerbation (group II). Clinical-laboratory and instrumental examination was performed. The West-Haven criteria were used to assess the HE.

Results. In 54.17% of patients in group І, the I degree of HE was determined, in 35.42% – the ІІ degree, in 10.42% – the ІІІ degree. In patients of group ІІ the HE of the І degree was found in 17.31%, the ІІ degree – in 50.0%, the ІІІ degree – in 32.69% (p<0.05). In patients with ALC and ALC in combination with CB, respectively, clinically HE was manifested by drowsiness in the daytime and the inversion of sleep (58.33%; 75.00%), lengthening the duration of the TMT-time test (61.59±2.38 sec; 72.84±3.03 sec), mood disorders (20.83%; 28.85%), appearance of asterixis (54.17%; 76.92%), constructive apraxia (41.67%; 55.77%).

Conclusions. 1. Exacerbation of CB in patients with ALC contributes to the increase in the degree of HE, worsening the prognosis. 2. The relationship between the hyponatremia and the degree of HE is revealed.


Keywords


alcoholic liver cirrhosis; chronic bronchitis; hepatic encephalopathy; hyponatremia

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DOI: http://dx.doi.org/10.21802/acm.2017.2.7

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