亚临床肝性脑病的流行病学调查

目的 了解亚临床肝性脑病(SHE)患病率及相关因素。 方法 对409例肝硬化患者进行数字连接试验(NCT)和数字符号试验(DST)检查。 结果 肝硬化患者SHE患病率为51.3％,肝硬化与正常对照组各年龄段及总的NCT、DST差异均有显著性,t=4.108～25.231,P<0.01。Child—pugh A、B、C级患者的患病率分别为39.9％(75/188)、55.2％(79/143)、71.8％(56/78),三组间差异有显著性,x2=23.910,P<0.01。小于35、35～44、45～54、55～64和大于64岁五个年龄段的患病率、性别、吸烟与否、酒精性和非酒精性肝硬化患者、不同文化程度,患者之间的患病率比较差异均无显著性。Logistic回归分析显示SHE患病率仅与Child—pugh分级相关,而与年龄、性别、吸烟、病因和文化程度无关。 结论 肝硬化患者SHE患病率为51.3％。Child-pugh分级是重要的危险因子。

An epidemiological survey of subclinical hepatic encephalopathy

Objective To investigate the prevalence and correlative factors of subclinical hepatic encephalopa-thy (SHE) in patients with cirrhosis in China by using psychometric tests with big sample size. Methods 409 patients with cirrhosis and 416 patients with chronic hepatitis were investigated for the prevalence of SHE. In prevalence study questionaire, psychometric tests (NCT and DST), laboratory data were used to estimate their liver funtion. Results According to age, the patients were divided into 5 groups (including <35, 35-44, 45-54, 55-64 and >65 groups). There was highly statistical signifance on the results of NCT and DST, between the cirrhosis patients and the controls (t > 4.108, P < 0.01). The prevalence of SHE in cirrhosis patients was 51.3%. Highly statistical significance was found ( x2 = 23.910, P < 0.01) among the Child-pugh A, B, C groups (39.9%, 55.2% and 71.8%). According to age, gender, smoking, etiology and education, no statistical significance was found. Logistic regression showed that there was a close relationship between the SHE prevalence and the Child-pugh score only, and no relationship had been found between the SHE prevalence and other factors including age, gender, smoking, etiology and education. Conclusions The SHE prevalence in hepatic cirrhosis patients is 51.3%, and the Child-pugh score may be an important risk factor.