Bahceci Funda, Yildirim Bulent, Karincaoglu Melih, Dogan Ibrahim, Sipahi Birsen
School of Medicine, Department on Internal Medicine, TR-44069, Malatya, Turkey.
J Natl Med Assoc. 2005 Feb;97(2):213-6.
Subclinical hepatic encephalopathy (HE) in cirrhotic patients is usually characterized by memory impairment and psychomotor slowing. Our aim was to investigate memory status in cirrhotic patients with and without clinically overt HE.
Thirty-two cirrhotic patients (10 female and 22 male) aged 49 +/- 17 years and 20 healthy subjects (six female and 14 male) aged 46 +/- 12 years were included in the study. Memory status was defined by Wechsler Memory Scale, verbal memory process and complex memory process tests.
Grade-1 HE was detected in 7 (22%) patients with cirrhosis. We detected 36 to 92% decrement in various memory tests in cirrhotic patients without HE as compared to healthy subjects. The scores for all psychometric testing results were significantly lower in cirrhotic patients without HE as compared to healthy subjects. We detected 42.9 to 100% decrement in various memory tests in cirrhotic patients with HE than cirrhotic patients without HE. However, there was no statistical significant difference between cirrhotic patients with and without HE. There was no statistical significant difference in cirrhotic patients with Child-Pugh A, B, and C.
In conclusion, memory status was influenced in which patients with cirrhosis yet has a normal mental and neurological status to routine clinical examination (subclinical HE). Occasionally, decreased memory performance may adversely affect the satisfaction and lifestyle of these patients. Therefore, subclinical HE is an important social problem.
肝硬化患者的亚临床肝性脑病（HE）通常表现为记忆障碍和精神运动迟缓。我们的目的是研究有无临床显性HE的肝硬化患者的记忆状况。
本研究纳入了32例年龄为49±17岁的肝硬化患者（10例女性，22例男性）和20例年龄为46±12岁的健康受试者（6例女性，14例男性）。通过韦氏记忆量表、言语记忆过程和复杂记忆过程测试来定义记忆状况。
7例（22%）肝硬化患者检测出1级HE。与健康受试者相比，无HE的肝硬化患者在各种记忆测试中的得分下降了36%至92%。无HE的肝硬化患者所有心理测量测试结果的得分均显著低于健康受试者。与无HE的肝硬化患者相比，有HE的肝硬化患者在各种记忆测试中的得分下降了42.9%至100%。然而，有HE和无HE的肝硬化患者之间无统计学显著差异。Child-Pugh A、B和C级的肝硬化患者之间也无统计学显著差异。
总之，肝硬化患者即使在常规临床检查中精神和神经状态正常（亚临床HE），其记忆状况也会受到影响。偶尔，记忆表现下降可能会对这些患者的满意度和生活方式产生不利影响。因此，亚临床HE是一个重要的社会问题。
