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[目的]探讨肝病患者日常行为能力异常筛查可疑轻微肝性脑病(MHE)的价值。[方法]509例住院肝病患者(肝硬化435例,肝衰竭74例),应用疾病影响程度量表(SIP)调查日常行为能力(包括7类21项日常生活行为);采用Child-Pugh分级法评价肝硬化患者肝功能严重程度;应用对照值经过年龄和文化程度矫正的数字连接测试和数字符号测试诊断MHE。采用χ2检验比较MHE阳性和MHE阴性患者日常行为能力异常情况,采用多元Logistic回归分析患者日常行为能力异常与MHE相关性。[结果]142例被诊断为MHE阳性患者(阳性率27.90%);21项生活能力中,MHE患者15项下降较MHE阴性患者明显(P<0.05~P<0.01)。其中“帮助他人兴趣下降”(P=0.01)、“会犯糊涂”(P=0.002)、“容易遗忘”(P=0.031)与MHE相关。[结论]肝硬化、肝衰竭患者部分日常行为能力下降与MHE相关,通过调查肝病患者日常行为可较好发现可疑的MHE患者。
[Objective] To investigate the value of abnormal screening of suspected mild hepatic encephalopathy (MHE) in patients with liver disease. [Methods] 509 hospitalized patients with liver disease (435 cases of liver cirrhosis and 74 cases of liver failure) were recruited. The daily behavioral abilities (including 21 kinds of daily activities in 7 categories) were investigated by using the Disease Influence Scale (SIP). Child-Pugh grading To assess the severity of liver function in cirrhotic patients; MHE was diagnosed using digital and digital sign-test controls that were age- and culture-adjusted. Chi-square test was used to compare the abnormal behavior of daily activities of patients with MHE-positive and MHE-negative, and multivariate logistic regression analysis was used to analyze the correlation between the patients’ daily behavioral abnormalities and MHE. [Results] 142 patients were diagnosed as MHE positive patients (the positive rate was 27.90%). Among the 21 patients, 15 decreased in MHE patients compared with those with negative MHE (P <0.05 ~ P <0.01). Among them, “helping to reduce interest in others” (P = 0.01), “confused” (P = 0.002), “easy to forget” (P = 0.031) were associated with MHE. [Conclusion] Some patients with cirrhosis and liver failure have decreased their daily behavioral abilities and are associated with MHE. Suspected MHE patients can be found better by investigating the daily behaviors of patients with liver diseases.