The prognosis of patients with hepatomegaly (HLD) is a major concern for patients and their families, and is an issue with which hepatomegaly specialists must be familiar. Fortunately, HLD is one of the few hereditary diseases that can be treated. If detected early, diagnosed early, and treated early, most patients can study and work like normal healthy people through systematic treatment under the guidance of a specialist. If they do not receive regular treatment, they usually die several years after the onset of the disease, mostly due to co-infection and liver failure, and rarely due to the rupture of the esophageal varices leading to haemorrhage in the upper gastrointestinal tract. Advanced cases that have developed a vegetative state or severe contracture deformities have a poor prognosis. Specifically, the prognosis of patients with hepatomegaly is related to a variety of factors. Zhengzhou People’s Hospital Brain Hospital Zhang Dongfeng 1. Genetic factors There are findings suggesting that patients with different clinical phenotypes of hepatomegaly have different efficacy responses. Therefore, it is clear that genetic factors are an important influence on the prognosis of patients with hepatomegaly. Abdominal hepatomegaly is rare and its clinical manifestations are similar to severe, fulminant hepatitis, with severe, aggressive and rapid progression, and most of them die within 2 weeks to 1 to 2 months after the onset of the disease. Modern molecular biology studies have found that the mutation site and type of ATP7B gene in abdominal hepatomegaly are different from other clinical phenotypes of hepatomegaly, and its gene expression results in a clinical phenotype with a very poor prognosis. In general, patients with pre-symptomatic or mild clinical manifestations of hepatomegaly can achieve a similar quality of life and life expectancy as normal after regular and systematic copper repellent therapy and adjuvant therapy. Therefore, we advocate patients to be vigilant and early diagnosis and regular and systematic treatment are extremely important to obtain a good prognosis. For patients with severe advanced disease, most of them can have different degrees of improvement after regular comprehensive copper treatment. The prognosis of different clinical types of hepatomegaly varies, although all patients have undergone regular and systematic copper expulsion therapy. Patients with hepatomegaly in the compensated stage of cirrhosis have no obvious organic damage to the central nervous system and no extrapyramidal symptoms, and most of them have a better prognosis after comprehensive copper expulsion therapy. The prognosis of patients with torsional spasticity hepatomegaly is poor. In contrast, patients with fulminant hepatic failure with hepatobiliary degeneration have a very high mortality rate. In addition, the prognosis of patients with the same type varies depending on the degree of organ damage to the liver and brain. In addition to symptomatic treatment of other types, it is important to adhere to long-term copper repellent treatment, therefore, patients and their families must cooperate closely with physicians in order to obtain more satisfactory results. 4. The prognosis is different with or without complications Some patients with hepatomegaly are complicated by immune deficiency, hypersplenism, pseudomyelitis, pneumonic pneumonia, urinary tract infection, pressure sores, fractures, acute upper gastrointestinal bleeding, hepatic encephalopathy, hepatorenal syndrome, seizures, depression, anxiety, mental disorders, etc. The above-mentioned complications often aggravate the disease and will certainly affect the patient’s treatment effect. Without timely and accurate management, the prognosis of some patients is worse than that of patients without complications. However, due to the presence of adverse reactions and numerous effects on liver damage and neurological function at the beginning of treatment such as transient or persistent exacerbation (this effect can occur in 20%-50% of patients). Some studies have shown that DMSA has better long-term efficacy than PCA, especially for those with PCA allergy or treatment failure. Another study showed that the urinary copper excretion before and after treatment with different copper chelators was in the order of DMPS, PCA, DMS, DMSA, and EDTA groups, from highest to lowest. The efficiency rate of each group after treatment was from high to low for DMPS group, DMS group, PCA group and DMSA group, and the difference between groups was very significant. The incidence of adverse reactions in each treatment group was PCA group, DMPS group, DMS group, DMSA group and EDTA group in descending order, and it was considered that the urinary copper excretion and efficiency of oral drugs were best in PCA and second in DMSA, while the injectable drugs were best in DMPS, second in DMS and worse in EDTA. In addition, studies on the effects of various copper repellent drugs on human lymphocytes have shown that DMSA, DMPS and PCA all have certain damage effects on human lymphocyte DNA; PCA has significantly higher DNA damage than DMPS and DMSA; DMPS and DMSA have similar DNA damage, and it is recommended that DMSA and DMPS be used as much as possible in the treatment of hepatomegaly. As copper repellent treatment, PCA is no longer emphasized as the drug of choice for the treatment of hepatomegaly, but should focus on individualized treatment selection according to the therapeutic effects, toxicity and adverse effects of copper repellent drugs, patients’ clinical symptoms, clinical examination results, etc. Therefore, different choices of copper repellent drugs for patients with the same condition have a significant impact on their prognosis. In conclusion, hepatomegaly is one of the few treatable neurogenetic diseases. Early (especially pre-symptomatic) diagnosis and timely, individualized and comprehensive copper repellent treatment can lead to the same life and life expectancy as a healthy person, but without regular treatment, it can eventually lead to disability and death.