Coskun Bdo, Ozen M, Gursoy S, Ozbakir O, Poyrazoglu O K, Baskol M, Sezgin G C, Yucesoy M
Department of Gastroenterology, Kayseri Training and Research Hospital, Kayseri, Turkey.
Department of Internal Medicine, Kayseri Training and Research Hospital, Kayseri, Turkey.
Niger J Clin Pract. 2017 Apr;20(4):421-426. doi: 10.4103/1119-3077.204375.
To construct normal values for the tests of the psychometric hepatic encephalopathy score (PHES) and evaluate the prevalence of minimal hepatic encephalopathy (MHE) among Turkish patients with liver cirrhosis.
One hundred and eighty-five healthy subjects and sixty patients with liver cirrhosis without overt hepatic encephalopathy were included in the study. All subjects underwent psychometric tests, which include number connection test-A and B (NCT-A/B), serial dotting test (DST), line drawing test (LDT), and digit symbol test (DST) in the same day. The variables that affected the results of the test were included in the multiple linear regression models and formulas were constructed to predict the expected results for each tests.
The results of all PHES tests, except the LDT in the cirrhotic group were significantly different than center of gravity (CG) (P < 0,001). The score of PHES in the cirrhotic group was -2,18 ± 3,3 (median -2; range: 11 to +4), significantly lower than CG (-0.31 ± 2.18 [median, 0; range, -8 to +5]) (P < 0.001). the cutoff of PHES was set -4 point. Therefore, 19 of the 60 cirrhotic patients were diagnosed with MHE (31.6%). Among the patients with MHE, 11 (11/45, 24,4%) had Child-Pugh classification (CTP) A and 8 (8/15, 53.3%) had CTP B. No differences in age and education years were found between the MHE and non-MHE groups (P > 0.05).
Turkish PHES normograms have been developed for detecting patients with MHE. Future multicenter national studies are needed to validate widely applicable norms.
构建心理测量肝性脑病评分（PHES）测试的正常值，并评估土耳其肝硬化患者中轻微肝性脑病（MHE）的患病率。
本研究纳入了185名健康受试者和60名无明显肝性脑病的肝硬化患者。所有受试者在同一天接受了心理测量测试，包括数字连接试验A和B（NCT-A/B）、连续打点试验（DST）、线图试验（LDT）和数字符号试验（DST）。将影响测试结果的变量纳入多元线性回归模型，并构建公式以预测每项测试的预期结果。
除肝硬化组的LDT外，所有PHES测试结果与重心（CG）组均有显著差异（P<0.001）。肝硬化组的PHES评分为-2.18±3.3（中位数-2；范围：-11至+4），显著低于CG组（-0.31±2.18[中位数，0；范围，-8至+5]）（P<0.001）。PHES的临界值设定为-4分。因此，60例肝硬化患者中有19例被诊断为MHE（31.6%）。在MHE患者中，11例（11/45，24.4%）为Child-Pugh分级（CTP）A，8例（8/15，53.3%）为CTP B。MHE组和非MHE组在年龄和受教育年限方面无差异（P>0.05）。
已制定土耳其PHES规范图以检测MHE患者。未来需要多中心全国性研究来验证广泛适用的规范。
