一位肝硬化病人發展出肝性腦病變。下列哪些實驗室發現支持此診斷？（選所有適合的）
A client with liver cirrhosis develops hepatic encephalopathy. Which of the following laboratory findings would support this diagnosis? (Select all that apply.)
- AElevated serum ammonia level✓ 正解血清氨濃度升高
- BDecreased serum albumin血清白蛋白降低
- CProlonged prothrombin time (PT)凝血酶原時間（PT）延長
- DLow platelet count血小板計數偏低
- EElevated serum bilirubin血清膽紅素升高
肝性腦病變（hepatic encephalopathy, HE）的核心病理為氨無法被肝臟代謝、進入腦部造成神經毒性。實驗室上「血氨升高」（elevated serum ammonia）是 HE 最直接、最具診斷支持力的指標（A）。其他選項雖然在肝硬化失代償時也異常，但都是反映肝功能受損或門脈高壓，並非 HE 本身的特異性指標：B. 白蛋白下降反映合成功能；C. PT 延長反映凝血因子合成不足；D. 血小板下降為門脈高壓與脾功能亢進；E. 膽紅素升高反映排泄功能受損。這些實驗值都會在肝硬化中出現，但無法單獨指向 HE。
Hepatic encephalopathy is primarily caused by the accumulation of ammonia due to the liver's inability to metabolize it, making elevated serum ammonia the most specific diagnostic indicator. While decreased albumin, prolonged prothrombin time, low platelets, and elevated bilirubin reflect general liver dysfunction or portal hypertension, they are not specific to the development of encephalopathy.
美國對於肝硬化病人的營養支持，常強調足夠的蛋白質攝取以避免肌肉流失；台灣亦同，但病人對此觀念的接受度可能因文化而異。