斯特鲁普测试在轻微型肝性脑病中的应用进展

高晓红; 李培燕; 彭芳

doi:10.3969/j.issn.1001-5256.2022.02.039

斯特鲁普测试在轻微型肝性脑病中的应用进展

DOI: 10.3969/j.issn.1001-5256.2022.02.039

延安大学附属医院感染病科，陕西延安 716000

基金项目:

延安大学附属医院科学技术研究发展计划项目 (2021PT-01)

利益冲突声明：所有作者均声明不存在利益冲突。

作者贡献声明：高晓红、李培燕参与起草文章关键内容；高晓红、李培燕、彭芳参与修改文章关键内容。

详细信息

通信作者:
李培燕, 2672130609@qq.com

计量
- 文章访问数: 641
- HTML全文浏览量: 161
- PDF下载量: 48
- 被引次数: 0
出版历程
- 收稿日期: 2021-06-11
- 录用日期: 2021-07-20
- 出版日期: 2022-02-20

Advances in the application of Stroop test in minimal hepatic encephalopathy

Department of Infectious Diseases, Affiliated Hospital of Yan'an University, Yan'an, Shaanxi 716000, China

Research funding:

Science and Technology Research and Development Project of Affiliated Hospital of Yan'an University (2021PT-01)

More Information

Corresponding author: LI Peiyan, 2672130609@qq.com

摘要

摘要: 轻微型肝性脑病(MHE)是肝性脑病的一个早期阶段，隐匿性强，临床漏诊率较高，早期诊断MHE并给予患者有效的临床干预至关重要。MHE的诊断方法有很多，目前常用的是肝性脑病心理学评分，由于操作繁琐、耗时长，限制了其在临床中的广泛应用，因此，临床亟待寻找简便、快速、有效的诊断方法。斯特鲁普测试(Stroop测试)是一种针对心理运动速度和认知灵活性的测试，其对MHE的诊断价值已在美国、韩国等多个国家得到验证。本文介绍了Stroop测试的发展及其在MHE中的应用进展。分析表明，基于移动设备的Stroop测试对诊断MHE具有较高的敏感度，且简便、可行，希望未来该测试能够在中国被广泛应用到筛查MHE的临床工作中。
- 肝性脑病 /
- 斯特鲁普测试 /
- 诊断
Abstract: Minimal hepatic encephalopathy(MHE) is an early stage of hepatic encephalopathy with an insidious onset and a high rate of missed diagnosis in clinical practice, and it is of great importance to diagnose MHE as early as possible and provide effective clinical intervention. There are many diagnostic methods for MHE, among which psychometric hepatic encephalopathy score is the most commonly used method at present, but its wide application in clinical practice is limited by its complex and time-consuming operation, and therefore, it is urgent to find a simple, rapid, and effective clinical diagnostic method. Stroop test is a test for psychomotor speed and cognitive flexibility, and its value in the diagnosis of MHE has been verified in various countries including the United States and South Korea. This article introduces the development of Stroop test and its application in MHE, and the analysis shows that Stroop test based on mobile devices has a high sensitivity in the diagnosis of MHE and is simple, convenient, and feasible. It is hoped that this test can be widely used in the clinical work of MHE screening in China in the future.
- Hepatic Encephalopathy /
- Stroop Test /
- Diagnosis

HTML全文

参考文献(30)

[1]	ELSAID MI, JOHN T, LI Y, et al. The health care burden of hepatic encephalopathy[J]. Clin Liver Dis, 2020, 24(2): 263-275. DOI: 10.1016/j.cld.2020.01.006.
[2]	LOUISSAINT J, TAPPER EB. Hepatic encephalopathy: A diagnosis for the individual but an experience for the household[J]. Clin Transl Gastroenterol, 2020, 11(5): e00181. DOI: 10.14309/ctg.0000000000000181.
[3]	Chinese Society of Hepatology, Clinese Medical Association. Guidelines on the management of hepatic encephalopathy in cirrhosis[J]. J Clin Hepatol, 2018, 34(10): 2076-2089. DOI: 10.3969/j.issn.1001-5256.2018.10.007. 中华医学会肝病学分会. 肝硬化肝性脑病诊疗指南[J]. 临床肝胆病杂志, 2018, 34(10): 2076-2089. DOI: 10.3969/j.issn.1001-5256.2018.10.007.
[4]	BAJAJ JS, O'LEARY JG, LEARY JG, et al. Hepatic encephalopathy is associated with mortality in patients with cirrhosis independent of other extrahepatic organ failures[J]. Clin Gastroenterol Hepatol, 2017, 15(4): 565-574.e4. DOI: 10.1016/j.cgh.2016.09.157.
[5]	TSATALI M, FOTIADOU F, GIAGLIS G, et al. The repeatable battery for the assessment of the neuropsychological status (RBANS): A diagnostic validity study in Greek elderly[J]. Aging Clin Exp Res, 2019, 31(9): 1305-1312. DOI: 10.1007/s40520-018-1076-9.
[6]	LABENZ C, BEUL L, TOENGES G, et al. Validation of the simplified Animal Naming Test as primary screening tool for the diagnosis of covert hepatic encephalopathy[J]. Eur J Intern Med, 2019, 60: 96-100. DOI: 10.1016/j.ejim.2018.08.008.
[7]	WANG YY, ZHAO YY, SUN SJ, et al. Value of psychometric hepatic encephalopathy score in the diagnosis of minimal hepatic encephalopathy in patients with liver cirrhosis[J]. J Clin Hepatol, 2018, 34(12): 2592-2598. DOI: 10.3969/j.issn.1001-5256.2018.12.017. 王砚砚, 赵宇阳, 孙书剑, 等. 神经心理测量评分对肝硬化患者轻微型肝性脑病的诊断价值[J]. 临床肝胆病杂志, 2018, 34(12): 2592-2598. DOI: 10.3969/j.issn.1001-5256.2018.12.017.
[8]	RANDOLPH C, HILSABECK R, KATO A, et al. Neuropsychological assessment of hepatic encephalopathy: ISHEN practice guidelines[J]. Liver Int, 2009, 29(5): 629-635. DOI: 10.1111/j.1478-3231.2009.02009.x.
[9]	FERENCI P, LOCKWOOD A, MULLEN K, et al. Hepatic encephalopathy-definition, nomenclature, diagnosis, and quantification: Final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998[J]. Hepatology, 2002, 35(3): 716-721. DOI: 10.1053/jhep.2002.31250.
[10]	COSKUN B, OZEN M, GURSOY S, et al. Normalization of the psychometric hepatic encephalopathy score for diagnosis of minimal hepatic encephalopathy in Turkey[J]. Niger J Clin Pract, 2017, 20(4): 421-426. DOI: 10.4103/1119-3077.204375.
[11]	LI SW, WANG K, YU YQ, et al. Psychometric hepatic encephalopathy score for diagnosis of minimal hepatic encephalopathy in China[J]. World J Gastroenterol, 2013, 19(46): 8745-8751. DOI: 10.3748/wjg.v19.i46.8745.
[12]	DJAMSHIDIAN A, O'SULLIVAN SS, SULLIVAN SS, et al. Stroop test performance in impulsive and non impulsive patients with Parkinson's disease[J]. Parkinsonism Relat Disord, 2011, 17(3): 212-214. DOI: 10.1016/j.parkreldis.2010.12.014.
[13]	ŞIMŞEK Ş, GENÇOǦLAN S, YVKSEL T, et al. Evaluation of the relationship between brain-derived neurotropic factor levels and the stroop interference effect in children with attention-deficit hyperactivity disorder[J]. Noro Psikiyatr Ars, 2016, 53(4): 348-352. DOI: 10.5152/npa.2016.10234.
[14]	FELIPO V, ORDOÑO JF, URIOS A, et al. Patients with minimal hepatic encephalopathy show impaired mismatch negativity correlating with reduced performance in attention tests[J]. Hepatology, 2012, 55(2): 530-539. DOI: 10.1002/hep.24704.
[15]	BAJAJ JS, THACKER LR, HEUMAN DM, et al. The Stroop smartphone application is a short and valid method to screen for minimal hepatic encephalopathy[J]. Hepatology, 2013, 58(3): 1122-1132. DOI: 10.1002/hep.26309.
[16]	BAJAJ JS, HEUMAN DM, STERLING RK, et al. Validation of EncephalApp, smartphone-based Stroop test, for the diagnosis of covert hepatic encephalopathy[J]. Clin Gastroenterol Hepatol, 2015, 13(10): 1828-1835.e1. DOI: 10.1016/j.cgh.2014.05.011.
[17]	LABENZ C, BARON JS, TOENGES G, et al. Prospective evaluation of the impact of covert hepatic encephalopathy on quality of life and sleep in cirrhotic patients[J]. Aliment Pharmacol Ther, 2018, 48(3): 313-321. DOI: 10.1111/apt.14824.
[18]	SINGH J, SHARMA BC, PURI V, et al. Sleep disturbances in patients of liver cirrhosis with minimal hepatic encephalopathy before and after lactulose therapy[J]. Metab Brain Dis, 2017, 32(2): 595-605. DOI: 10.1007/s11011-016-9944-5.
[19]	SAMANTA J, DHIMAN RK, KHATRI A, et al. Correlation between degree and quality of sleep disturbance and the level of neuropsychiatric impairment in patients with liver cirrhosis[J]. Metab Brain Dis, 2013, 28(2): 249-259. DOI: 10.1007/s11011-013-9393-3.
[20]	LUO M, YU XB, HU SJ, et al. EncephalApp Stroop App predicts poor sleep quality in patients with minimal hepatic encephalopathy due to hepatitis B-induced liver cirrhosis[J]. Saudi J Gastroenterol, 2020, 26(3): 120-128. DOI: 10.4103/sjg.SJG_558_19.
[21]	ALLAMPATI S, DUARTE-ROJO A, THACKER LR, et al. Diagnosis of minimal hepatic encephalopathy using Stroop EncephalApp: A multicenter US-based, norm-based study[J]. Am J Gastroenterol, 2016, 111(1): 78-86. DOI: 10.1038/ajg.2015.377.
[22]	WANG L, ZHU X, LI J, et al. Value of Stroop Smartphone App in screening minimal hepatic encephalopathy[J]. Chin J Neuromed, 2017, 16(7): 711-714. DOI: 10.3760/cma.j.issn.1671-8925.2017.07.012. 王黎, 朱璇, 李洁, 等. 手机版斯特鲁谱测试在筛查轻微型肝性脑病中的应用价值[J]. 中华神经医学杂志, 2017, 16(7): 711-714. DOI: 10.3760/cma.j.issn.1671-8925.2017.07.012.
[23]	SURESH MV, JAGADISAN B, KANDASAMY P, et al. Stroop test validation to screen for minimal hepatic encephalopathy in pediatric extrahepatic portal venous obstruction[J]. J Pediatr Gastroenterol Nutr, 2018, 66(5): 802-807. DOI: 10.1097/MPG.0000000000001895.
[24]	YOON EL, JUN DW, JEONG JY, et al. Validation of the Korean Stroop test in diagnosis of minimal hepatic encephalopathy[J]. Sci Rep, 2019, 9(1): 8027. DOI: 10.1038/s41598-019-44503-w.
[25]	ZENG X, LI XX, SHI PM, et al. Utility of the EncephalApp Stroop Test for covert hepatic encephalopathy screening in Chinese cirrhotic patients[J]. J Gastroenterol Hepatol, 2019, 34(10): 1843-1850. DOI: 10.1111/jgh.14656.
[26]	ZENG X, ZHANG LY, LIU Q, et al. Combined scores from the EncephalApp Stroop test, number connection test B, and Serial dotting test accurately identify patients with covert hepatic encephalopathy[J]. Clin Gastroenterol Hepatol, 2020, 18(7): 1618-1625.e7. DOI: 10.1016/j.cgh.2019.11.018.
[27]	GOU LB, ZHANG W, GUO DJ, et al. Aberrant brain structural network and altered topological organization in minimal hepatic encephalopathy[J]. Diagn Interv Radiol, 2020, 26(3): 255-261. DOI: 10.5152/dir.2019.19216.
[28]	BAJAJ JS, SAEIAN K, SCHUBERT CM, et al. Minimal hepatic encephalopathy is associated with motor vehicle crashes: The reality beyond the driving test[J]. Hepatology, 2009, 50(4): 1175-1183. DOI: 10.1002/hep.23128.
[29]	HANAI T, SHIRAKI M, WATANABE S, et al. Prognostic significance of minimal hepatic encephalopathy in patients with liver cirrhosis in Japan: A propensity score-matching analysis[J]. J Gastroenterol Hepatol, 2019, 34(10): 1809-1816. DOI: 10.1111/jgh.14635.
[30]	WANG YL, SHAO LC, YANG Z. Diagnostic value of number connection test for minimal hepatic encephalopathy and related factors of cirrhosis complicated with hepatic encephalopathy[J]. Clin J Med Offic, 2020, 48(12): 1424-1426, 1429. DOI: 10.16680/j.1671-3826.2020.12.11. 王雨丽, 邵丽春, 杨卓. 数字连接试验对轻微肝性脑病诊断价值及肝硬化并发肝性脑病相关因素分析[J]. 临床军医杂志, 2020, 48(12): 1424-1426, 1429. DOI: 10.16680/j.1671-3826.2020.12.11.