肝硬化的亚临床肝性脑病患病率研究

目的 :进行较全面的国人亚临床肝性脑病 (SHE)患病率调查及相关因素分析。方法 :对 4 0 9例肝硬化患者进行数字连接 (NCT)和数字符号试验 (DST) ,16 8例健康人和 188例溃疡病或胆囊结石患者组成正常对照组。结果 :1.肝硬化患者SHE患病率为 5 1.3%。 2 .Child - pughA、B、C级患者的SHE患病率分别为 39.9% (75 / 188) ,5 5 2 % (79/ 14 3) ,71.8% (5 6 / 78) ,三组间差异有显著性 (P <0 .0 1)。按照年龄、性别、吸烟、病因、文化程度进行分组 ,它们的患病率差异无显著性。 3.Logistic回归分析显示SHE患病率仅与Child - pugh分级相关 (P <0 .0 1) ,而与年龄、性别、吸烟、病因和文化程度无关 (P >0 .0 5 ) .Child - pugh分级OR =2 .0 ,是危险因子。结论 :应重视肝硬化患者中SHE的高患病率状况 ,建议运用NCT和DST对高危人群作早期诊断。

The Prevalence of Subclinical Hepatic Encephalopathy in Hepatic Cirrhosis

Objective:To investigate the prevalence of subclinical hepatic encephalopathy(SHE) in patients with cirrhosis in China with big sample size.Methods:409 patients with cirrhosis were investigated for the prevalence of SHE.168 healthy subjets and 188 patients with peptic ulcer or cholelithiasis without neuropathy and mental disorders were eligible as controls.Results:The prevalence of SHE in cirrhosis was 51.3%.Highly statistical significance was found ( P <0.01) among the Child-pugh score A,B,C groups(39.9%:55.2%:71.8%).According to age,gender,smoking,etiology and education,no statistical significance was found ( P >0.05) among these groups.The logistic regression showed that there was a close relationship between the SHE prevalence and the Child-pugh scores( P <0.01).However,no correlation had been found between the SHE prevalence and other factors including age,gender,smoking,etiology and education( P >0.05).The OR of Child-pugh score was 2.0 which showed it was a risk factor.Conclusions:It is important to give serious consideration to the hepatic cirrhosis patients with high prevalence of SHE,and it is suggested to use the NCT and DST to diagnose the SHE patient in risk individuals at early stage.