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

Zhang LiJie; Zhou YingXia; Xing HuiChun; Su Ye; Sun YuMei

doi:10.3969/j.issn.1001-5256.2018.04.015

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Apr. 2018

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

DOI: 10.3969/j.issn.1001-5256.2018.04.015

School of Nursing, Peking University

Published Date: 2018-04-20

Abstract

Abstract

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.
- hepatitis B, chronic,
- liver cirrhosis,
- hepatic encephalopathy,
- neuropsychological tests

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References(16)

References

[1]YAN M.Selection of the diagnostic and therapeutic methods for minimal hepatic encephalopathy[J].J Clin Hepatol, 2016, 32 (6) :1092-1099. (in Chinese) 阎明.轻微型肝性脑病诊治方法的选择[J].临床肝胆病杂志, 2016, 32 (6) :1092-1099.

[2]BAJAJ JS, CORDOBA J, MULLEN KD, et al.Review article:the design of clinical trials in hepatic encephalopathy——an International Society for Hepatic Encephalopathy and Nitrogen Metabolism (ISHEN) consensus statement[J].Aliment Pharmacol Ther, 2011, 33 (7) :739-747.

[3]ENNAIFER R, CHEIKH M, HEFAIEDH R, et al.Minimal hepatic encephalopathy:a better diagnostic to improve prognostic[J].Presse Med, 2014, 43 (5) :e127-e133.

[4]Chinese Society of Hepatology, Chinese Society of Infectious Diseases, Chinese Medical Association.The guideline of prevention and treatment for chronic hepatitis B (2010 version) [J].J Clin Hepatol, 2011, 27 (1) :Ⅰ-ⅩⅥ. (in Chinese) 中华医学会肝病学分会, 中华医学会感染病学分会.慢性乙型肝炎防治指南 (2010版) [J].临床肝胆病杂志, 2011, 27 (1) :Ⅰ-ⅩⅥ.

[5] KE E.The valuation of nerve electrophysiology and intelligence tests in the diagonosis of minimal hepatic encephalopathy in patients with cirrhosis[D].Guangzhou:Guangzhou Med Univ, 2015. (in Chinese) 柯娥.神经电生理及智能检测在肝硬化患者轻微肝性脑病诊断中的价值评估[D].广州:广州医科大学, 2015.

[6]SU L, SUN YM, LIN KK, et al.Investigation of cognitive functions in patients with chronic hepatitis B[J].J Pract Hepatol, 2012, 15 (4) :312-314. (in Chinese) 苏莉, 孙玉梅, 林可可, 等.慢性乙型肝炎患者认知功能的调查研究[J].实用肝脏病杂志, 2012, 15 (4) :312-314.

[7]SUN YM, ZHOU YX, XING HC, et al.Clock drawing test in cognitive assessment for patients with hepatitis B cirrhosis[J].J Clin Hepatol, 2015, 31 (3) :413-417. (in Chinese) 孙玉梅, 周英霞, 邢卉春, 等.画钟测验对乙型肝炎肝硬化患者认知功能的评估[J].临床肝胆病杂志, 2015, 31 (3) :413-417.

[8] Chinese Society of Gastroenterology and Chinese Society of Hepatology, Chinese Medical Association.Consensus on the diagnosis and treatment of hepatic encephalopathy in China (Chongqing, 2013) [J].Chin J Dig, 2013, 33 (9) :81-93. (in Chinese) 中华医学会消化病学分会.中国肝性脑病诊治共识意见 (2013年, 重庆) [J].中华消化杂志, 2013, 33 (9) :81-93.

[9]HAO LC, HU YQ, HOU XH.The relationship between the daily behavior abnormalities and minimal hepatic encephalopathy in patients with cirrhosis or liver failure[J].Chin J Clin Gastroenterol, 2017, 29 (3) :151-154. (in Chinese) 郝良成, 胡阳黔, 侯晓华.肝硬化和重症肝炎患者日常行为异常与轻微肝性脑病关系的探讨[J].临床消化病杂志, 2017, 29 (3) :151-154.

[10]CAO ZL.Studies on illness perception and neuropsychology of patients with chronic HBV infection[D].Hefei:Anhui Med Univ, 2007. (in Chinese) 曹召伦.慢性乙型肝炎病毒感染者疾病认知与神经心理学研究[D].合肥:安徽医科大学, 2007.

[11]WANG Q, LI W, MAO LW, et al.The role of connection test (Chinese Revision) in early identification of dementia free vascular cognitive impairment[J].Chin J Gerontol, 2012, 32 (10) :2018-2020. (in Chinese) 王琦, 李文, 毛礼炜, 等.连线测验 (中文修订版) 在早期识别无痴呆型血管性认知障碍中的作用[J].中国老年学杂志, 2012, 32 (10) :2018-2020.

[12]SHARMA P, SHARMA BC.Predictors of minimal hepatic encephalopathy in patients with cirrhosis[J].Saudi J Gastroenterol, 2010, 16 (3) :181-187.

[13]XIE HG.Cognitive impairment and neuropsychological assessment in Alzheimer's disease[J].Chin J Prac Intern Med, 2010, 30 (10) :883-887. (in Chinese) 解恒革.阿尔茨海默病认知障碍表现与量表检测[J].中国实用内科杂志, 2010, 30 (10) :883-887.

[14]ZHANG LJ, YIN JZ, QI J.The f MRI study of cognitive control in cirrhotic patients[J].J Clin Radiol, 2008, 27 (2) :163-167. (in Chinese) 张龙江, 尹建忠, 祁吉.肝硬化患者认知控制的f MRI研究[J].临床放射学杂志, 2008, 27 (2) :163-167.

[15]YOU XQ, YAN BH.Characteristics of the cognition processing of human visual ability in space[J].J Shaanxi Normal Uni (Philos Social Sci Edit) , 2004, 33 (2) :102-107. (in Chinese) 游旭群, 晏碧华.视觉空间能力的认知加工特性[J].陕西师范大学学报 (哲学社会科学版) , 2004, 33 (2) :102-107.

[16]FU YZ, XIE JW.The application of clock drawing test and MMSE in diagnosis of minimal hepatic encephalopathy[J].J Clin Res, 2007, 24 (8) :1280-1282. (in Chinese) 符应征, 谢俊维.画钟试验和MMSE在轻微肝性脑病诊断中的应用[J].医学临床研究, 2007, 24 (8) :1280-1282.

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

DOI: 10.3969/j.issn.1001-5256.2018.04.015