Liver Unit, Pomeranian Medical University, Szczecin, Poland.
Liver Int. 2011 Aug;31(7):980-4. doi: 10.1111/j.1478-3231.2011.02465.x. Epub 2011 Feb 10.
Minimal hepatic encephalopathy (HE) is a serious complication of cirrhosis; however, the impact of minimal HE on health-related quality of life (HRQoL) remains controversial. The Psychometric Hepatic Encephalopathy Score (PHES) remains a 'gold standard' for the assessment of minimal HE, but its results clearly differ between studied populations.
We studied the effect of minimal HE on patient HRQoL.
Eighty-seven consecutive cirrhotic patients were included. All patients underwent clinical and psychometric evaluation at the same day. Ten subjects with overt HE confirmed with West Haven criteria were excluded from the study, thus 77 patients were finally analysed. Patients with minimal HE were identified on the grounds of altered PHES. HRQoL was assessed by the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) and the Chronic Liver Disease Questionnaire (CLDQ). Normative reference data for PHES were established from a cohort of 305 healthy Polish subjects.
Twenty-nine (37.7%) patients were diagnosed with minimal HE. When patients with and without minimal HE were compared, HRQoL was not significantly different in none of the SF-36 and CLDQ domains.
Minimal HE does not affect HRQoL.
轻微型肝性脑病(HE)是肝硬化的严重并发症;然而,轻微型 HE 对健康相关生活质量(HRQoL)的影响仍存在争议。精神测量性肝性脑病评分(PHES)仍然是评估轻微型 HE 的“金标准”,但其结果在不同的研究人群中明显不同。
我们研究了轻微型 HE 对患者 HRQoL 的影响。
纳入了 87 例连续的肝硬化患者。所有患者均在同一天进行临床和心理测量评估。排除了 10 例根据 West Haven 标准确诊为显性 HE 的患者,因此最终分析了 77 例患者。根据 PHES 改变确定了轻微型 HE 患者。使用健康调查 36 项简短量表(SF-36)和慢性肝病问卷(CLDQ)评估 HRQoL。PHES 的正常参考数据是从 305 名健康波兰受试者队列中建立的。
29 例(37.7%)患者被诊断为轻微型 HE。在比较有和无轻微型 HE 的患者时,SF-36 和 CLDQ 的各个领域的 HRQoL 均无显著差异。
轻微型 HE 不影响 HRQoL。