轻微肝性脑病患病情况调查及相关危险因素分析  

Prevalence of minimal hepatic encephalopathy and analysis of associated risk factors

作　　者：李素文[1] 许建明[2] 胡凯风[1] 张倩倩[2] 王敏[2] 吴琪芳[2] 

机构地区：[1]安徽医科大学第四附属医院消化内科,安徽合肥230022 [2]安徽医科大学第一附属医院消化内科

出　　处：《胃肠病学和肝病学杂志》2012年第2期176-179,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的本研究应用简易智能量表(MMSE)及数字连接试验-A(NCT-A)筛查住院肝硬化患者轻微肝性脑病(MHE)的患病情况,同时进行营养风险筛查2002(NRS 2002)筛查工作,纳入MHE危险因素分析。方法连续调查239例肝硬化患者,对91例符合入选标准的患者进行MMSE、NCT-A检测,并进行NRS 2002筛查。排除显性肝性脑病(OHE)后,如MMSE或NCT-A任何一项检测阳性或两项均阳性,则诊断为MHE。NRS 2002≥3分,判定为存在营养风险。结果检测91例肝硬化患者,排除显性肝性脑病12例,余79例中,NCT-A阳性31例(39.2%),MMSE阳性6例(7.6%),两者均阳性2例(2.5%),诊断MHE 35例(44.3%)。肝功能Child B/C组MHE患者明显多于Child A组(P=0.023),与<50岁(13/46)的肝硬化患者相比,≥50岁(22/33)的MHE更多见(P=0.001)。未发现营养风险等因素对MHE有影响(P>0.05)。结论住院肝硬化患者中存在相当高比例的MHE(44.3%),NCT-A检测MHE敏感性明显高于MMSE,但MMSE有利于发现早期OHE。住院肝硬化患者年龄越大、肝功能Child分级越差,MHE越多。Objective To investigate the prevalence of MHE of inpatients with cirrhosis by mini-mental state examination（MMSE） and number connection test-A（NCT-A）,and to find out the risk factors of MHE.Methods In all 239 consecutive cirrhotic patients,91 patients,who met the inclusion criteria,were screened by MMSE,NCT-A and NRS 2002.After exclusion of overt hepatic encephalopathy（OHE）,MHE was defined as presence of at least one abnormal psychometric test.The nutritional risk was defined as NRS≥3.Results After exclusion of 12 OHE patients in all 79 cirrhotic patients,31 cirrhotic patients（39.2%） were abnormal with NCT-A only,6 patients（7.6%） with MMSE,2 patients（2.5%） with both MMSE and NCT-A.Taken together,MHE was diagnosed in 35 patients（44.3%）.The prevalence of MHE increased from 27.6% in Child A group to 54.0% in Child B and C group（P=0.023）.The prevalence of MHE increased from 28.3% in 50 yrs group to 66.7% in ≥50 yrs group（P=0.001）.No correlation was found between nutritional risk and MHE（P=0.491）.Conclusion MHE could be found in 44.3% of cirrhotic inpatients.NCT-A is more sensitive than MMSE in the detection of MHE,but MMSE may detect early OHE.The prevalence of MHE is significantly correlated with Child-Pugh＇s grade and age of cirrhotic patients.

关 键 词：轻微肝性脑病 简易智能量表 数字连接试验-A 

分 类 号：R575[医药卫生—消化系统]