智力测验调查肝病患者轻微型肝性脑病的发病学

Investigate the prevalence of minimal hepatic encephalopathy in patients with hepatic cirrhosis or chronic hepatitis by Psychometric tests

目的对肝硬化和慢性肝炎患者的轻微型肝性脑病发病状况进行调查。方法对400例肝硬化患者和416例慢性肝炎患者进行数字连接试验(NCT)和数字符号试验(SDT)。结果肝硬化患者中NCT异常率为38·0%,SDT异常率为41·8%,二项均异常为29·3%,至少有一项异常(即MHE发病率)为51·0%。MHE发病率和性别、年龄、吸烟、饮酒无关,但和肝功能Child-pugh分级相关。A级肝硬化患者MHE发病率为39·8%,B级发病率为54·4%,C级发病率为72·4%。三级之间有显著性差异(P<0·01)。慢性肝炎患者的MHE发病率为7·2%,显著低于肝硬化组(P<0·01)。结论肝硬化MHE发病率为51·0%,显著高于慢性肝炎的7·2%。MHE发病率与肝功能Child-pugh分级相关,与性别、年龄、病因、吸烟无关。

Objectvie To investigate the prevalence of minimal hepatic encephalopathy （MHE） in patients with hepatic cirrhosis or chronic hepatitis. Methods 400 consecutive patients with cirrhosis and 416 with chronic hepatitis without clinical encephalopathy were screened by the number connection test A （NCT-A） and the symbol digit test （SDT） . The normal values of NCT and SDT were obtained from 356 peoples without liver diseases. Normal ranges of NCT and SDT were between the mean ±2 deviation. Results 38.0% patients were abnormal in NCT and 41.8% in SDT. 29. 3% in both tests, 51.0% in at least one test, who were diagnosed of having MHE. According to Child-pugh grade, 39.8% patients were diagnosed of having MHE in grade A, 54.4% in grade B, and 72.4% in grade C. Highly statistical significance were found among 3 groups. In cirrhotic patient groups, etiology, age, gender and smoking habit had no relation to MHE prevalence. The MHE prevalence of chronic hepatitis （7.2% ） differed significantly from that of cirrhosis （P 〈 0.01 ） . Conclution The MHE prevalence in cirrhotic patients without overt hepatic encephalopathy was 51.0% and was linked to the severity of liver disease, but had no relationship with gender, age, etiology, and smoking. The MHE prevalence of chronic hepatitis （7.2%） differed significantly from cirrhosis （P〈0. 01） .