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乙型肝炎肝硬化并发轻微肝性脑病的调查分析
An investigation of minimal hepatic encephalopathy in patients with hepatitis B cirrhosis
文章发布日期:2018年03月07日  来源:  作者:张丽洁,周英霞,邢卉春,等  点击次数:122次  下载次数:15次

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【摘要】:目的调查乙型肝炎肝硬化患者轻微肝性脑病(MHE)的发生情况。方法分别选择2012年6月-2012年12月在首都医科大学附属北京地坛医院门诊就诊的乙型肝炎肝硬化患者(肝硬化组)与健康对照组各105例,采用数字连接试验、Stroop色词测验、画钟测验3项神经心理学测验进行认知功能测评。计量资料2组间比较采用t检验或Wilcoxon秩和检验,计数资料2组间比较采用χ2检验。结果肝硬化组完成NCT-A、NCT-B和CWT-A、CWT-B、CWT-C的耗时明显长于健康对照组(t值分别为-2.158、-2.372、-2.063、-2.611、-4.325,P值均<0.05),而CDT-1得分要明显低于健康对照组(t=2.884,P<0. 05)。乙型肝炎肝硬化患者中共筛出MHE 46例(43.81%),其中,信息加工速度异常者最高为24例(22.86%),其次为反应抑制能力异常者17例(1619%),视觉空间能力异常者15例(14.29%),定势转移能力异常者10例(9.52%)。结论肝功能稳定的乙型肝炎肝硬化患者MHE的检出率较高,联合使用神经心理学测试可以提高MHE的检出率。
【Abstract】:ObjectiveTo investigate the prevalence of minimal hepatic encephalopathy (MHE) in patients with hepatitis B cirrhosis. MethodsA total of 105 patients with hepatitis B cirrhosis who visited Beijing Ditan Hospital, Capital Medical University, from June to December, 2012 were enrolled as cirrhosis group, and 105 healthy volunteers were enrolled as healthy control group. The number connection test (NCT), Stroop color-word test (CWT), and clock drawing test (CDT) were used to evaluate cognitive function. The t-test or the Wilcoxon rank-sum test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsCompared with the healthy control group, the cirrhosis group had significantly longer time spent on NCT-A, NCT-B, CWT-A, CWT-B, and CWT-C (t=-2.158, -2.372, -2.063, -2.611, and -4.325, all P<0.05) and a significantly lower score of CDT-1 (t=2.884, P<0.05). Of all patients with hepatitis B cirrhosis, 46 (43.81%) were diagnosed with MHE, among whom 24 (22.86%) had an abnormal information processing speed, 17 (16.19%) had an abnormal reaction inhibition ability, 15 (14.29%) had an abnormal visuospatial ability, and 10 (9.52%) had an abnormal set-shifting ability. ConclusionThere is a high detection rate of MHE in patients with hepatitis B cirrhosis and stable liver function, and a combination of neuropsychological tests can increase the detection rate of MHE.
【关键字】:肝炎, 乙型, 慢性; 肝硬化; 肝性脑病; 神经心理学测验
【Key words】:hepatitis B, chronic; liver cirrhosis; hepatic encephalopathy; neuropsychological tests
【引证本文】:ZHANG LJ, ZHOU YX, XING HC, et al. An investigation of minimal hepatic encephalopathy in patients with hepatitis B cirrhosis[J]. J Clin Hepatol, 2018, 34(4): 770-774. (in Chinese)
张丽洁, 周英霞, 邢卉春, 等. 乙型肝炎肝硬化并发轻微肝性脑病的调查分析[J]. 临床肝胆病杂志, 2018, 34(4): 770-774.

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