肝性脑病患者的发病以及病情程度与其脑电图变化的关系

Correlation between onset and severity of hepatic encephalopathy and electroencephalogram changes

目的:探讨肝性脑病(hepatic encephalopathy,H E)患者的发病以及病情程度与其脑电图(electroencephalogram,EEG)变化的关系.方法:选择河南大学淮河医院2013-06/2014-06期间收治的HE患者共78例作为观察组,并选择同期健康体检者73例作为空白对照组,采用脑电记录仪进行EEG描记分析,并根据EEG结果划分EEG的异常程度,观察组两组受检者EEG异常的分布情况,比较其与HE的发生以及临床分期的关系.结果:(1)观察组患者EEG轻度异常19例,中度异常37例,重度异常11例,其EEG异常率高达85.90%(67/78),而对照组仅8例表现为轻度异常,EEG异常率仅为10.96%(8/73),两组间差异具有统计学意义(P<0.05);(2)在78例HE患者中,EEG轻度异常多发生在HE前驱期,而EEG重度异常则多发生在HE昏迷期,可见随着HE病情的加剧,EEG的异常程度越严重,两者呈正相关(P<0.05).结论:HE患者的发病以及病情程度与其EEG的变化密切相关,因而EEG可以作为HE患者的一项诊断指标及监测病情变化的重要手段,该法值得在临床上推广使用.

AIM： To explore the relationship between the onset and severity of hepatic encephalopathy（HE） and electroencephalogram（EEG） changes.METHODS： Seventy-eight patients with HE treated at our hospital from June 2013 to June 2014 were included as an observation group, and 73 healthy people were used as a control group. An EEG recorder was used for EEG analysis. The degree of abnormality of EEG was graded according to the EEG results. The distribution of EEG abnormalities in the two groups of subjects was compared. The relationships between EEG changes and the onset and clinical stages of HE were analyzed.RESULTS： The observation group had an overall EEG abnormality rate of up to 85.90%, with 19 patients having mild EEG abnormalities, 37 aving moderate abnormalities, and 11 having severe abnormalities. The control group had an overall EEG abnormality rate of 10.96%, with only 8 patients showing mild EEG abnormalities. The EEG abnormality rate was significantly different between the two groups（P〈0.05）. In 78 patients with HE, mild EEG abnormalities often occurred in the prodromal period of HE, while severe abnormalities often occurred in the coma period of HE. With the aggravation of HE, the degree of EEG abnormalities became severe, and there was a positive correlation between them（P〈0.05）. CONCLUSION： The onset and severity of HE are closely related to EEG changes. EEG can be used as a diagnostic marker and an important means of monitoring changes in the condition of patients with HE.