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基于回归的数字连接测试 A 和数字符号测试的中文版常模用于诊断轻微肝性脑病。

Regression-based Chinese norms of number connection test A and digit symbol test for diagnosing minimal hepatic encephalopathy.

机构信息

Institute of Liver Disease, Beijing University of Chinese Medicine, Beijing, China.

Department of Gastroenterology and Hepatology, Beijing University of Chinese Medicine Affiliated Dongfang Hospital, Beijing, China.

出版信息

Sci Rep. 2024 Feb 18;14(1):4005. doi: 10.1038/s41598-024-54696-4.

Abstract

Number connection test A (NCT-A) and digit symbol test (DST), the preferential neuropsychological tests to detect minimal hepatic encephalopathy (MHE) in China, haven't been standardized in Chinese population. We aimed to establish the norms based on a multi-center cross-sectional study and to detect MHE in cirrhotic patients. NCT-A and DST were administered to 648 healthy controls and 1665 cirrhotic patients. The regression-based procedure was applied to develop demographically adjusted norms for NCT-A and DST based on healthy controls. Age, gender, education, and age by education interaction were all predictors of DST, while age, gender, and education by gender interaction were predictors of log NCT-A. The predictive equations for expected scores of NCT-A and DST were established, and Z-scores were calculated. The norm for NCT-A was set as Z ≤ 1.64, while the norm for DST was set as Z ≥ - 1.64. Cirrhotic patients with concurrent abnormal NCT-A and DST results were diagnosed with MHE. The prevalence of MHE was 8.89% in cirrhotic patients, and only worse Child-Pugh classification (P = 0.002, OR = 2.389) was demonstrated to be the risk factor for MHE. The regression-based normative data of NCT-A and DST have been developed to detect MHE in China. A significant proportion of Chinese cirrhotic patients suffered from MHE, especially those with worse Child-Pugh classification.

摘要

数字连接测试 A(NCT-A)和数字符号测试(DST)是在中国检测轻微型肝性脑病(MHE)的首选神经心理学测试,但尚未在中国人群中标准化。我们旨在通过一项多中心横断面研究建立基于人群的标准,并在肝硬化患者中检测 MHE。对 648 名健康对照者和 1665 名肝硬化患者进行了 NCT-A 和 DST 测试。采用回归方法,根据健康对照者建立了年龄、性别、教育程度以及年龄与教育程度交互作用校正的 DST 测试结果的正常参考值。年龄、性别和性别与教育程度交互作用是 log NCT-A 的预测因子。建立了 NCT-A 和 DST 预期得分的预测方程,并计算了 Z 分数。将 NCT-A 的正常参考值设定为 Z≤1.64,DST 的正常参考值设定为 Z≥-1.64。同时存在 NCT-A 和 DST 异常结果的肝硬化患者被诊断为 MHE。肝硬化患者中 MHE 的患病率为 8.89%,仅较差的 Child-Pugh 分级(P=0.002,OR=2.389)被证明是 MHE 的危险因素。已经制定了基于回归的 NCT-A 和 DST 的正常参考数据,用于在中国检测 MHE。相当一部分中国肝硬化患者患有 MHE,尤其是那些 Child-Pugh 分级较差的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e4b/10874952/3e93e330076f/41598_2024_54696_Fig1_HTML.jpg

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