简易智能测试和事件相关电位P300对312例轻微肝性脑病诊断的对照研究

A study on Psychometric measures and ERP- P300 in diagnosis of minimal hepatic encephalopathy

目的：研究简易智能测试和事件相关电位P300（ERP-P300）对轻微肝性脑病（MHE）的诊断。方法：选择416名健康志愿者按年龄分为〈35岁组、35-44岁组、45-54岁组和55-64岁组,全部接受简易智能测试和ERP-P300检测,建立与年龄相关的正常人群均值及标准差,以均数±2标准差作为MHE的诊断标准,用于检测312名肝硬化患者,随访1年、2年后2种诊断方法的肝性脑病发病率。结果：416名健康志愿者的数字连接试验（NCT-A）在〈35岁组、35-44岁组、45-54岁组和55~64岁组分别为（24.9±4.8）s、（31.8±6.7）s、（39.2±6.9）s、（48.9±6.7）s,数码-符号试验（DST）分数分别为49.7±4.8、45.2±4.7、38.3±4.7、35.8±4.5。312名肝硬化患者以此为标准,通过简易智能测试和ERP-P300诊断的MHE分别为46.2%（144/312）、63.5%（198/312）,随访1年和2年后通过简易智能测试MHE的发病率为91.0%（131/144）和96.5%（139/144）,通过ERP-P300检测MHE的发病率为92.9%（184/198）和96.4%（191/198）。结论：简易智能测试和ERP-P300均可用于MHE的诊断并可判断临床预后。

Objective： To study Psychometric measures and ERP - P300 in diagnosis of minimal hepatic encephalopathy. Methods：416 healthy volunteers （aged 25 to 64 years） were divided into 〈35ys, 35 -44ys, 45 -54ys and 55 -64ys groups. All of the healthy volunteers were assessed with NCT - A, DST and ERP - P300 to establish the normal value of age - related parameters, which can be used for diagnosis of MHE in patients with live cirrhosis. Two standard deviation of the normal mean was used as a diagnostic criterion for MHE. 312 cirrhotic patients were assessed with these parameters. After one or two years, the rate of HE is revealed by psychometric measures and ERP - P300. Results： The parameters of NCT - A were （24.9±4.8） sec in 〈35ys group, （31.8 ±6. 7 ） sec in 35 - 44ys group, （39.2 ± 6.9） sec in 45 - 54ys group or （48.9 ±6.7 ） sec in 55 - 64ys group. The scores of DST were 49. 7±4.8 in 〈35ys group, 45.2 -±4.7 in 35 -44ys group, 38.3 ±4.7 in45 -54ys group or35.8 ±4.5 in55 -64ys group. 144 of 312 cirrhotic patients were diagnosed as MHE based on these psychometric parameters. 198 of 312 cirrhotic patients were diagnosed as MHE based on ERP - P300. After one or two years, the rate of HE（ psychometric parameters） was 91.0% （131/144） ,96.5% （ 139/ 144）, the rate of HE（ ERP- P300） was 92.9% （184/198） ,96.4% （191/198）. Conclusions： Psychometric measures and ERPP300 can be used for diagnosis of MHE, and judge prognosis of live cirrhosis. Normal parameters of psychometric measures and ERP - P300 should be established.