Weissenborn Karin, Krause Jochen, Bokemeyer Martin, Hecker Hartmut, Schüler Andreas, Ennen Jochen C, Ahl Björn, Manns Michael P, Böker Klaus W
Department of Neurology, Medizinische Hochschule Hannover, 30623 Hannover, Germany.
J Hepatol. 2004 Nov;41(5):845-51. doi: 10.1016/j.jhep.2004.07.022.
BACKGROUND/AIMS: Up to 50% of patients infected with the hepatitis C virus (HCV) complain of chronic fatigue and difficulties in concentration and memory. The aim of the present study was to seek evidence for the presence of central nervous system involvement in HCV infected patients with only mild liver disease.
Thirty HCV infected patients with normal liver function, 15 of whom were identified as having mild and 15 moderate to severe fatigue using the fatigue impact scale, underwent neurological and neuropsychological examination, electroencephalography (EEG) and cerebral proton magnetic resonance imaging (MRI) and spectroscopy (MRS). Fifteen healthy volunteers, matched for age and educational attainment, served as controls.
In comparison to the healthy controls the patients with HCV infection showed evidence of cognitive impairment, primarily attention and higher executive functions, higher levels of anxiety and depression and impairment of quality of life. In addition they showed a significant decrease of the N-acetyl-aspartate/creatine ratio in the cerebral cortex on 1H MRS while the EEG was slowed in 25%. In general the deficits were more marked in the patients with moderate rather than mild fatigue.
The data provide evidence of central nervous system involvement in patients with HCV infection.
背景/目的：高达50%的丙型肝炎病毒（HCV）感染者抱怨有慢性疲劳以及注意力和记忆力方面的问题。本研究的目的是寻找证据，以证明仅患有轻度肝病的HCV感染患者存在中枢神经系统受累情况。
30例肝功能正常的HCV感染患者，其中15例根据疲劳影响量表被确定为有轻度疲劳，15例为中度至重度疲劳，他们接受了神经学和神经心理学检查、脑电图（EEG）以及脑质子磁共振成像（MRI）和波谱分析（MRS）。15名年龄和受教育程度相匹配的健康志愿者作为对照。
与健康对照相比，HCV感染患者表现出认知障碍的证据，主要是注意力和高级执行功能方面，焦虑和抑郁水平更高，生活质量受损。此外，他们在1H MRS上显示大脑皮质中N-乙酰天门冬氨酸/肌酸比值显著降低，同时25%的患者脑电图减慢。总体而言，中度疲劳患者的缺陷比轻度疲劳患者更明显。
这些数据为HCV感染患者存在中枢神经系统受累提供了证据。
