探讨脑诱发电位检测亚临床型肝性脑病的价值

目的:评价脑诱发电位(EP)诊断亚临床型肝性脑病(SHE)的价值。方法:对48例肝炎肝硬化患者进行三种脑诱发电位检查。并追踪1年观察临床肝性脑病出现情况。结果:三种脑诱发电位总异常26例(54％),其中听觉诱发电位(BAEP)异常18饲(37.5％)、视觉诱发电位(VEP)异常3例(6.2％)、体感诱发电位(SEP)异常10例(20.8％),以BAEP异常事最高。追踪观察1年的29例患者中,15例脑诱发电位异常者出现临床肝性脑病11例(73％),无脑诱发电位异常14例中,出现临床肝性脑病4例(28％)(p<0.05)。结论:提示BAEP对诊断SHE最敏感,同时三种诱发电位检查可提高SHS的检出率,检测SHE对预测肝性脑病的发生有临床价值。

The Value of Evoked Potentials Examination in Detection of Subclinical Hepatic Encephalopathy

To Explore the value of evoked potentials (EPO in detection of Subclinical Hepatic Encephalopathy (SHE). Methods: Evoked potentials were performed in 48 patients with oiver cirrhosis and followed up for one year to detect the development of overt hepatic encephalopathy (HE). Results: Psychometric tests were abnormal in 16 (44%) in which verbal ability was abnormal in 12 patients (33%) and performance test in 14 patients (38%). Three kinds of evoked potentials were abnormal in 18 (50%) patients in which brainstem evoked potential (BAEPO was abnormal in 12(33%) ,visual evoked potential (VEP) in 3(8%) and somatosensory evoked potential (SEP) in 6 patients (16%). Evoked potentials and/or psychometric tests were abnormal in 28(77% ). three kinds of evoked potentials were abnormal in 26 patients(54% ). Among 34 cases followed up for one year, 19(73%) of 26 with abnormal evoked potential developed overt hepatic encephathy, compared to 2 of 8.925% with normal evoked potential (p<0.05). Conclusions: There was added advantage of performing three kinds of EP in a patient for the detection of SHE which help to predict the development of overt hepatic encephalopathy.