肝炎肝硬化并发亚临床肝性脑病的诊断研究

目的探讨及评价亚临床性肝性脑病(SHE)早期诊断的方法。方法对116例肝炎肝硬化患者进行3项心理智能测试及3项脑电诱发电位(EP)检测,并与正常人群比较。结果心理智能测试异常率为58.6%,显著高于EP检测异常率25.9%,两者总异常率达68.0%(80/116例)。6项测试中以数字连接试验(NCT)异常率最高(50%);将患者按Child-Pugh进行肝功能分级,B/C级患者(90例)中心理智能测试异常率为68.9%,心理智能测试与EP检测总异常率为77.8%,显著高于A级患者(26例)心理智能测试异常率(23%,P<0.01)及心理智能测试与EP检测总异常率(38.5%,P<0.01)。结论心理智能测试比EP检测敏感,二者在SHE的诊断中有相互补充的作用;NCT是最敏感的单项测试方法;心理智能测试异常率及SHE发生率的高低与肝脏病变及肝功能损害的严重程度相一致。

Diagnosis of subclinical hepatic encephalopathy in liver cirrhosis

Objective To evaluate the early diagnosis of subclinical hepatic encephalopathy(SHE) in patients with liver cirrhosis . Methods 116 cirrhosis patients were studied by 3 kinds of intelligent mental test and 3 kinds of evoked potential (EP) test ,and the results were compared with that of normal population. Results The abnormal rate of intelligent mental test was 58.6% in cirrhosis patients ,which was much higher than that of EP test, and the positive rate was 68.9%(80/116). The abnormal rate of numeral connection test (NCT) was the highest (50%) in the 6 kinds of tests.Patients were ranked by liver function according to Child-Pugh class and the intelligent mental test abnormal rate in 90 class B/C patients was 68.9%,and the total abnormal rate was 77.8%,much higher than that in class A patients (23%,P<0.01;and 38.5%,P<0.01), respectively.Conclusion Intelligent mental test is more sensitive than EP test for the diagnosis of SHE; NCT is the most sensitive test method; the abnormal rate of intelligent mental test and the rate of SHE are consistent with the degree of liver malfunction.