Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Center of Clinical Epidemiology and Evidence-based Medicine, Fudan University, Shanghai 200032, China.
World J Gastroenterol. 2013 Aug 14;19(30):4984-91. doi: 10.3748/wjg.v19.i30.4984.
To investigate the prevalence of minimal hepatic encephalopathy (MHE) and to assess corresponding health-related quality of life (HRQoL) in hospitalized cirrhotic patients in China.
This multi-center cross-sectional study included 16 teaching hospitals, which were members of "Hepatobiliary Cooperation Group, Society of Gastroenterology, Chinese Medical Association", from different areas of China carried out between June and October in 2011. All the eligible hospitalized cirrhotic patients (n = 538) were required to complete triplicate number connection tests combined with one digit symbol test for diagnosing MHE. Patients' clinical examination data were complemented by a modified questionnaire assessing HRQoL. Written informed consent was obtained from each patient.
Male was predominant (68.6%) in 519 patients who met the criteria of the study, with a mean age of 49.17 ± 11.02 years. The most common cause of liver cirrhosis was chronic hepatitis B (55.9%). The prevalence of MHE was 39.9% and varied by Child-Pugh-Classification score (CPC-A: 24.8%, CPC-B: 39.4% and CPC-C: 56.1%, P < 0.01). MHE (P < 0.01) and higher CPC scores (P < 0.01) were associated with a high HRQoL scores (reflecting poorer quality of life). The prevalence of MHE was proportionate to CPC (P = 0.01) and high quality of life scores (P = 0.01).
Hospitalized cirrhotic patients have a high prevalence of MHE that is proportionate to the degree of liver function and HRQoL impairment.
调查中国住院肝硬化患者轻微型肝性脑病（MHE）的患病率，并评估其相应的健康相关生活质量（HRQoL）。
这项多中心横断面研究包括中国不同地区的 16 家教学医院，这些医院均为“中华医学会消化病学分会肝胆协作组”的成员。研究于 2011 年 6 月至 10 月进行，纳入了所有符合条件的住院肝硬化患者（n=538），要求他们完成 3 次数字连接测试联合 1 次数字符号测试以诊断 MHE。患者的临床检查数据由评估 HRQoL 的改良问卷补充。每位患者均获得了书面知情同意。
符合研究标准的 519 例患者中，男性占主导地位（68.6%），平均年龄为 49.17±11.02 岁。肝硬化最常见的病因是慢性乙型肝炎（55.9%）。MHE 的患病率为 39.9%，且因 Child-Pugh 分级评分（CPC-A：24.8%，CPC-B：39.4%和 CPC-C：56.1%，P＜0.01）而异。MHE（P＜0.01）和更高的 CPC 评分（P＜0.01）与较高的 HRQoL 评分相关（反映生活质量较差）。MHE 的患病率与 CPC（P=0.01）和较高的生活质量评分（P=0.01）呈比例关系。
住院肝硬化患者 MHE 的患病率较高，且与肝功能和 HRQoL 损害程度成正比。
