心理智能测验检测肝动脉化疗栓塞对肝癌合并肝硬化患者亚临床肝性脑病的影响

Evaluation of Psychometric Tests in Detecting Subclinical Hepatic Encephalopathy in Patients with Hepatocellular Carcinoma Accompanying Cirrhosis after Transcatheter Arterial Chemoembolization

目的：用心肝理智能测验研究原发性肝癌合并肝硬化患者并发亚临床肝性脑病（SHE）的情况，了解肝动脉化疗栓塞（TACE）治疗时SHE的影响，并探讨心理智能测验能否作为判断TACE治疗后SHE变化的指标。方法：用数字连接试验（NCT）、数字符号试验（DSy）与数字广度试验（DSP）3种心理智能测验对81例原发性肝癌合并肝硬化并接受TACE治疗的患者及50例对照进行检测，其中48例患者在TACE治疗后2周进行复查。结果：患者组与对照组各项心理智能测验结果存在显著差异，81例患者中共检出SHE20例（24．7％）。患者组TACE治疗前后检查结果无显著差异。因学习效应的影响，对照组2周后复查的成绩明显优于第1次。结论：SHE在原发性肝癌合并肝硬化患者中有一定的发生率。心理智能测验同存在学习效应，不宜作为判断某种治疗对SHE影响的指标。

Background/Aims: To study the subclinical hepatic encephalopathy (SHE) by psychometric tests in patients with hepatocellular carcinoma accompanying cirrhosis and to evaluate the reliability of psychometric tests in detecting the development of SHE after transcatheter arterial chemoembolization (TACE). Methods: 81 patients with hepatocellular carcinoma.accompanying cirrhosis and 50 controls were detected with number-connection test (NCT), digital symbol test (DSy) and digital span test (DSp). 48 patients were re-examined two weeks after TACE. Results: 20 out of 81 patients were diagnosed as SHE, there were no significant changes in the psychometric tests after TACE. The controls got better results in the re-examination after two weeks when they got used to it. Conclusions:SHE gave a frequency rate of 24.7% in patients with hepatocellular carcinoma accompanying cirrhosis in this study, and psychometric tests can not be taken as a marker for judging presence or absence of SHE after therapy, because these patients are acquainted with the tests performed beforhand.