Department of Gastroenterology, Institute of Medicine, Maharajgunj, Nepal.
Department of Internal Medicine, College of Medical Sciences, Chitwan, Nepal.
JNMA J Nepal Med Assoc. 2020 Jan;58(221):29-32. doi: 10.31729/jnma.4809.
Among patients with Hepatic Encephalopathy, prevalence of Minimal HE varies between 30-50%. Identifying patients with MHE has been shown to improve with medications and delay development of Overt HE, however only limited clinicians screen for MHE in patients due to time consuming neuropsychological and neurophysiological tests. The Number Connection Test is an easy way to evaluate patients to diagnose MHE. The aim of this study is to find out the prevalence of covert hepatic encephalopathy.
The descriptive cross-sectional study was done to find out the prevalence of covert hepatic encephalopathy among patients with chronic liver disease. To diagnose Covert HE which included MHE as well, NCT was used in Devanagari script.
The prevalence of covert hepatic encephalopathy is found to be 56 (58.3%) at 90% confidence interval (58.23-58.37%). A total of 96 patients (71.9% male) were diagnosed as HE, with mean age of 49.6+11.8 years. The cause of CLD in 85 (88.5%) of these patients was alcohol, of which 76 (79.2%) consumed locally brewed alcohol. Of these 96 patients with HE, only 40 (41.7%) had overt HE. Among all these, maximum patients had MHE (37.5%).
Our study showed that although the prevalence of minimal HE is quite high among cirrhotics, they are usually missed in clinical practice due to absence of symptoms. Active screening with easy-to-administer tests, like Number Connection tests, can help identify patients with minimal HE and hence treat them early.
在肝性脑病患者中，轻微肝性脑病的患病率在 30-50%之间。已证实，识别出 MHE 患者可通过药物治疗改善，并延缓显性肝性脑病的发展，但由于神经心理学和神经生理学测试耗时，仅有有限的临床医生对患者进行 MHE 筛查。数字连接测试是一种评估患者以诊断 MHE 的简便方法。本研究旨在确定隐匿性肝性脑病的患病率。
这项描述性横断面研究旨在确定慢性肝病患者中隐匿性肝性脑病的患病率。为了诊断包括 MHE 在内的隐匿性肝性脑病，使用了数字连接测试（NCT）的梵文字符。
在 90%置信区间（58.23-58.37%）内，发现隐匿性肝性脑病的患病率为 56（58.3%）。共有 96 名（71.9%为男性）患者被诊断为 HE，平均年龄为 49.6+11.8 岁。这些患者中 85 例（88.5%）的 CLD 病因是酒精，其中 76 例（79.2%）饮用本地酿造的酒精。在这 96 名患有 HE 的患者中，仅有 40 名（41.7%）患有显性 HE。在所有这些患者中，最多的患者患有 MHE（37.5%）。
我们的研究表明，尽管轻微肝性脑病在肝硬化患者中患病率相当高，但由于缺乏症状，在临床实践中通常会被漏诊。通过易于管理的测试（如数字连接测试）进行积极筛查，可以帮助识别出患有轻微肝性脑病的患者，并及早进行治疗。
