護理師監測肝硬化病人是否出現肝性腦病變。哪項檢驗值與此併發症最直接相關？
The nurse monitors a client with cirrhosis for signs of hepatic encephalopathy. Which laboratory value is most closely associated with this complication?
- ASerum creatinine血清肌酸酐
- BSerum albumin血清白蛋白
- CSerum potassium血清鉀
- DSerum ammonia✓ 正解血清氨
肝性腦病變 (Hepatic encephalopathy) 是肝硬化常見的嚴重併發症。肝臟是代謝蛋白質產生之氨 (Ammonia) 的主要器官，透過尿素循環將其轉化為尿素排出。當肝功能嚴重衰竭，氨無法被代謝而蓄積在血中，穿過血腦屏障引起神經毒性，導致意識改變、躁動甚至昏迷。因此，血氨值是評估此併發症的關鍵指標。
Hepatic encephalopathy is a common and serious complication of cirrhosis. The liver is the primary organ that metabolizes the ammonia produced from protein breakdown, converting it through the urea cycle into urea for excretion. When liver function is severely impaired, ammonia is not metabolized and accumulates in the blood, crossing the blood-brain barrier to produce neurotoxicity that causes altered consciousness, agitation, and even coma. Thus, the serum ammonia level is the key indicator for evaluating this complication.