An investigation of minimal hepatic encephalopathy in patients with hepatitis B cirrhosis

Objective To investigate the prevalence of minimal hepatic encephalopathy (MHE) in patients with hepatitis B cirrhosis.Methods A total of 105 patients with hepatitis B cirrhosis who visited Beijing Ditan Hospital, Capital Medical University, from June to December, 2012 were enrolled as cirrhosis group, and 105 healthy volunteers were enrolled as healthy control group.The number connection test (NCT) , Stroop color-word test (CWT) , and clock drawing test (CDT) were used to evaluate cognitive function.The t-test or the Wilcoxon rank-sum test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups.Results Compared with the healthy control group, the cirrhosis group had significantly longer time spent on NCT-A, NCT-B, CWT-A, CWT-B, and CWT-C (t =-2.158, -2.372, -2.063, -2.611, and-4.325, all P < 0.05) and a significantly lower score of CDT-1 (t = 2.884, P < 0.05) .Of all patients with hepatitis B cirrhosis, 46 (43.81%) were diagnosed with MHE, among whom 24 (22.86%) had an abnormal information processing speed, 17 (16.19%) had an abnormal reaction inhibition ability, 15 (14.29%) had an abnormal visuospatial ability, and 10 (9.52%) had an abnormal set-shifting ability.Conclusion There is a high detection rate of MHE in patients with hepatitis B cirrhosis and stable liver function, and a combination of neuropsychological tests can increase the detection rate of MHE.