Особливості порушення біоелектричної активності головного мозку у пацієнтів з печінковою енцефалопатією

Abstract

The purpose of the study was to determine the relationship between the bioelectrical activity of the brain and the severity of hepatic encephalopathy. Materials and methods. We examined 99 patients with hepatic encephalopathy due to chronic hepatitis (51 patients, including 26 men and 25 women) and liver cirrhosis (48 patients, including 32 men and 16 women). The age of patients is 51.2±9.5 years. According to outpatient cards, all patients were examined in the gastroenterology departments of clinics in Kharkiv, where chronic hepatitis and liver cirrhosis and their etiology, if necessary, were diagnosed based on clinical-laboratory and instrumental examination. The term of chronic hepatitis from diagnosis was 8.1±3.9 years, liver cirrhosis – 2.1±0.5 years. The bioelectrical activity of the brain was recorded on a 12-channel computer electroencephalographic complex DX-NT32 in a state of restful wakefulness and under functional loads. Results. The increase in the severity of hepatic encephalopathy was accompanied by a decrease in the frequency and percentage contribution of alpha rhythm in combination with an increase in the percentage contribution to slow wave activity. The presence of a number of pathological changes that were detected on the electroencephalogram in the studied group of patients with hepatic encephalopathy is also noteworthy. Thus, in patients with stage II hepatic encephalopathy, bilateral synchronous acute "three-phase waves" were registered, mainly in the front-temporal leads. To determine the relationship between impaired bioelectrical activity of the brain and impaired liver function, a correlation was made between the indicators of electroencephalogram and the content of ammonia in the blood in groups of patients with chronic hepatitis and cirrhosis. The correlation analysis revealed a negative relationship between the content of ammonia in the blood and the frequency of the alpha rhythm (r = -0.58; r = -0.69; p <0.05), a direct relationship between the content of ammonia and the percentage contribution of slow wave activity (r = + 0.61; r = + 0.63, p <0.05) in groups of patients with chronic hepatitis and liver cirrhosis, respectively. The data obtained support the link between impaired brain bioelectrical activity and liver dysfunction due to chronic hepatitis and liver cirrhosis. Conclusion. Thus, electroencephalogram in a comprehensive examination of patients with chronic liver disease can track the dynamics of the clinical course of hepatic encephalopathy, and the changes on the electroencephalogram can serve as an additional marker of the severity of hepatic encephalopathy, which is especially important in detecting hepatic encephalopathy in the latent stage