Badea Mircea Alexandru, Drug Vasile Liviu, Dranga Mihaela, Gavrilescu Otilia, Stefanescu Gabriela, Popa Iolanda, Mihai Catalina, Cijevschi-Prelipcean Cristina
Department of Gastroenterology, University of Medicine and Pharmacy "Grigore T. Popa" Iasi, Strada Universitatii, Nr. 16, code, 700115, Iasi, Romania.
Institute of Gastroenterology and Hepatology, Iasi, Romania.
Metab Brain Dis. 2016 Dec;31(6):1463-1471. doi: 10.1007/s11011-016-9878-y. Epub 2016 Jul 27.
The psychometric hepatic encephalopathy score (PHES) is frequently used as a "gold standard" for the diagnosis of minimal hepatic encephalopathy (MHE). In Romania, there are currently no widely available tests for the detection of MHE. In this study we aimed to standardize the PHES in a healthy Romanian population and to estimate the prevalence of MHE in a group of Romanian patients with liver cirrhosis. A total of 260 healthy volunteers and 106 patients with liver cirrhosis were included in the study. The five neuropsychological tests comprising the PHES were administered to all enroled subjects. Blood samples for routine tests and serum ammonia were collected. In the healthy volunteer group age and education years were found to be predictors of all tests and gender only in two tests: digit symbol test and serial dotting test. The PHES of the healthy volunteer group was 0,43 ± 1,37 and the cut-off between normal and pathological values was set at -3 points. In the liver cirrhosis group the mean PHES was -2,44 ± 3,41, significantly lower than in the control group (p = 0,001). The estimated prevalence of MHE was 34,7 % (37 patients). In patients with cirrhosis there was a significant correlation between PHES and the severity of the liver disease according to Child-Pugh classification (r = 0,529, p = 0,001) and MELD score (r = -0,525, p = 0,001). According to our results, accurate Romanian PHES norms for the diagnosis of MHE have been developed. MHE was diagnosed in a significant proportion of Romanian patients with liver cirrhosis.
心理测量肝性脑病评分（PHES）常被用作诊断轻微肝性脑病（MHE）的“金标准”。在罗马尼亚，目前尚无广泛可用的检测MHE的方法。在本研究中，我们旨在规范罗马尼亚健康人群的PHES，并估计一组罗马尼亚肝硬化患者中MHE的患病率。该研究共纳入了260名健康志愿者和106名肝硬化患者。对所有纳入的受试者进行了包含PHES的五项神经心理学测试。采集了用于常规检查和血清氨检测的血样。在健康志愿者组中，年龄和受教育年限是所有测试的预测因素，而性别仅在两项测试中具有预测作用：数字符号测试和连续打点测试。健康志愿者组的PHES为0.43±1.37，正常与病理值之间的临界值设定为-3分。在肝硬化组中，平均PHES为-2.44±3.41，显著低于对照组（p = 0.001）。MHE的估计患病率为34.7%（37例患者）。在肝硬化患者中，根据Child-Pugh分类法，PHES与肝病严重程度之间存在显著相关性（r = 0.529，p = 0.001），与终末期肝病模型（MELD）评分也存在显著相关性（r = -0.525，p = 0.001）。根据我们的研究结果，已制定出用于诊断MHE的准确的罗马尼亚PHES规范。在相当比例的罗马尼亚肝硬化患者中诊断出了MHE。
