Value of blood ammonia and cholinesterase in the early diagnosis of liver cirrhosis with minimal hepatic encephalopathy

Xuhong YANG; Yong YANG; Minglei WANG; Wenxiao LIU; Wanlong MA; Minxing WANG; Xiangchun DING; Xiaodong WANG

doi:10.3969/j.issn.1001-5256.2023.02.013

Volume 39 Issue 2

Feb. 2023

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Article Navigation > Journal of Clinical Hepatology > 2023 > 39(2): 339-344

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Value of blood ammonia and cholinesterase in the early diagnosis of liver cirrhosis with minimal hepatic encephalopathy

DOI: 10.3969/j.issn.1001-5256.2023.02.013

Xuhong YANG^1a,
Yong YANG^1b,
Minglei WANG^2a,
Wenxiao LIU^1a,
Wanlong MA^2b,
Minxing WANG^1a,
Xiangchun DING^{2b
,
,
,},
Xiaodong WANG^{2a, 1b
,
,
,}

1a.
School of Clinical Medicine, Ningxia Medical University, Yinchuan 750004, China
1b.
Key Laboratory of Craniocerebral Diseases, Ningxia Medical University, Yinchuan 750004, China
2a.
Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan 750004, China
2b.
Department of Infectious Diseases, General Hospital of Ningxia Medical University, Yinchuan 750004, China

Research funding:

Natural Science Foundation of Ningxia (2022AAC03487);

Science and Technology Key Research Program of Ningxia (2019BEG03037);

School-level Scientific Research Project of Ningxia Medical University (XM2021069)

More Information

Corresponding author: DING Xiangchun, 13619511768@163.com (ORICD: 0000-0003-0283-9419); WANG Xiaodong, xdw80@yeah.net (ORICD: 0000-0003-3535-8208)
Received Date: 2022-07-13
Accepted Date: 2022-08-14
Published Date: 2023-02-20

Abstract

Abstract

Objective To investigate the value of serum markers in the early diagnosis of liver cirrhosis with minimal hepatic encephalopathy (MHE). Methods A prospective analysis was performed for 81 patients who were hospitalized and treated in General Hospital of Ningxia Medical University from April 2020 to February 2022, and all these patients were diagnosed with hepatitis B cirrhosis based on clinical manifestation, laboratory examination, and radiological examination or liver biopsy. According to digital connection test A (NCT-A) and digital symbol test (DST), these patients were divided into simple cirrhosis group with 45 patients and MHE group with 36 patients. Related indices were measured, including liver function [alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), and total bilirubin (TBil)], albumin, blood ammonia, cholinesterase, and prothrombin time. The independent samples t-test was used for comparison of normally distributed continuous data between two groups; the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups, and the Kruskal-Wallis H test was used for comparison between multiple groups; the chi-square test was used for comparison of categorical data between groups. The logistic regression analysis and the area under the ROC curve (AUC) were used to investigate the predictive factors for MHE. Results Compared with the simple cirrhosis group, the MHE group had a significant increase in NCT-A score (Z=-7.110, P < 0.001) and a significant reduction in DST score (t=12.223, P < 0.001). The univariate analysis showed that there were significant changes in AST, albumin, prothrombin time, cholinesterase, and blood ammonia in the patients with MHE (Z=-2.319, -2.643, -1.982, -6.594, and -5.331, all P < 0.05), while the multivariate analysis showed that only cholinesterase and blood ammonia were significant predictive factors (all P < 0.05) and were correlated with Child-Pugh score (all P < 0.05). Cholinesterase, blood ammonia, and their combination had an AUC of 0.925, 0.845, and 0.941, respectively, in the diagnosis of MHE, with an optimal cut-off value of 2966, 60, and 0.513, respectively. Conclusion Blood ammonia, cholinesterase, and their combined measurement have a potential clinical value in the early diagnosis of liver cirrhosis with MHE.
- Liver Cirrhosis,
- Hepatic Encephalopathy,
- Hyperammonemia,
- Cholinesterases,
- Early Diagnosis

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References

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Value of blood ammonia and cholinesterase in the early diagnosis of liver cirrhosis with minimal hepatic encephalopathy

DOI: 10.3969/j.issn.1001-5256.2023.02.013

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