Evaluation Study On Psychometric Hepatic Encephalopathy Score System In The Diagnosis Of Minimal Hepatic Encephalopathy And Its Related Factors

Objective:Discussion the influence factors of Psychometric Hepatic Encephalopathy Score (PHES)system and minimal hepatic encephalopathy (MHE) diagnostic value; Survey of patients withliver cirrhosis minimal hepatic encephalopathy prevalence rate and the correlation factor;Forimproving local population PHES system normal reference value range provided evidence-based medical information.Method:Investigation from April2011to April2012in jilin university hospital between thefellowship hospital and age18in frequency138cases of patients with liver cirrhosis (cirrhosisgroup). One type of symptoms of hepatic encephalopathy (overt hepatic encephalopathy, OHE)20cases of patients, no OHE in118cases; Outpatient service medical or hospitalized patientswith accompanying family,108cases of no liver disease adult volunteers (the normal controlgroup). All participants take PHES system test, Through the normal control group is likely toaffect the factors, more factors analysis, a calculation formula of the normal expected rangecan be established. Cirrhosis compared to the group. If PHES system <-4is scoring diagnosislight miniature hepatic encephalopathy (MHE), and analyzes MHE risk factors.The subjects ofthis study of informed consent and the signature.Results:Group1OHE in liver cirrhosis patient20cases,13cases of men and women in7cases,age45to64years, average57.4±8.3years old, by the education time for an average of9.55±3.85years; No OHE118cases of patients with liver cirrhosis,89cases of men, women29cases, aged30to64years old, average (47.4±11.4years old, by the education time for an average of10.55±4.72years, Child-Pugh A level in49cases, Child-Pugh B level in45cases,Child-Pugh grade C=24. Analysis results show that cause liver cirrhosis, liver cirrhosis51cases after viral hepatitis, alcoholic cirrhosis48cases, other reason19cases. Normal controlgroup108examples,77cases of men, women and an example, age26~64years old, average48.1±12.4years old, by the education time for an average of12.78±4.12years; The twogroups in age, educational level, drinking, smoking, professional compares difference have noobvious (P>0.05). Age, gender, education by time, smoking, alcohol consumption,professional, causes the factor into the many factors in the model, the application of multipleregression analysis, the results showed that age and education by time and PHES system arelinearly related, the greater the age, education by the lower level, the worse PHES system testscores. Sex, smoking, alcohol consumption, professional, causes and factors of PHES had noeffect on the system. PHES system set up by the education degree age, related expectedformulas for the normal reference value: Digital connection test-A (NCT-A)=30.70+0.631by1.504by age-by education time, improved digital connection test-B (NCT-BC)=54.93+1.134by2.574by age-by education time, number symbols test (DST)=29.90-0.332by age+2.670by the time by education, track describe test (LTT)=48.82+0.496by1.120by age-byeducation time, series (SDT) rbis test=54.35+0.402by1.266by age-by education time. Liver cirrhosis from all objects PHES group system test results and the normal control groupset up according to the age, education degree by relevant expected normal reference valuecalculation formula result comparison, PHES score <-4namely system for MHE diagnosis. NoOHE patients than the existence of patients PHES OHE1score increased significantly, whichare free of OHE patients median-5.5, four points digits for5,1phase spacing OHE patientsmedian-10, four points digits spacing for5.5, with significant differences between the twogroups (P <0.01). No OHE in patients with PHES system the four points of proportion ofthere was significantly lower than the1) OHE patients, OHE patients without PHES system in62(52.5%),type1in patients with existing OHE for16(80%), two groups of comparisons P <0.01. No OHE hospitalization of patients with liver cirrhosis light miniature hepatic encephalopathy (MHE) prevalence was52.5%. Application Logistic regression analysis, theresults showed that prevalence MHE only and Child-pugh grading related, OR=2.3, is therisk factors, that is, the more serious damage to the liver function, MHE detection rate is high,and with age, sex, smoking, cultural degree and the cause is irrelevant.Conclusion:PHES system for the diagnosis of minimal hepatic encephalopathy with a specificity ofdiagnostic significance, and shall establish and age, education degree by relevant expectednormal reference value range; Jilin university sino-japanese friendship hospital patients withcirrhosis MHE prealence was52.5%, Child-pugh classification is an important risk factors.The PHES system in our country to confirm the range of normal reference value still needs tobe a large sample of epidemiological survey. Attention should be paid to in patients with livercirrhosis MHE morbidity of the situation, the proposal PHES system routine use high-riskpatients for screening, do it early diagnosis and early treatment, prevent illness development,reduce the incidence of related events.