简化版动物命名实验对轻微肝性脑病的诊断作用

肝脏 ›› 2021, Vol. 26 ›› Issue (5): 494-496.

简化版动物命名实验对轻微肝性脑病的诊断作用

王娜, 戴夫, 郑吉顺, 彭琼, 徐鹤翔, 陈利雪

230001 合肥安徽医科大学第三附属医院消化内科(王娜,戴夫,彭琼),感染科(郑吉顺,徐鹤翔);
安徽医科大学附属第一医院消化内科(陈利雪)

收稿日期:2020-10-04 出版日期:2021-05-31 发布日期:2021-06-17
通讯作者: 戴夫,Email:hfsdf@sina.com;郑吉顺,Email:zhengjishun1@163.com
基金资助:
中国肝炎防治基金会天晴肝病研究基金(TQGB20180226);合肥市卫生计生委应用医学研究重点项目(hwk2016zd003)

Diagnosis performance of simplified animal naming experiment on minimal hepatic encephalopathy

WANG Na¹, DAI Fu¹, ZHENG Ji-shun², PENG Qiong¹, XU He-xiang², CHEN Li-xue³

Department of ¹Gastroenterology and ²Infection, the Third Affiliated Hospital of Anhui Medical University, Hefei 230001, China;
³Department of Gastroenterology, the First Affiliated Hospital of Anhui Medical University, Hefei 230000, China

Received:2020-10-04 Online:2021-05-31 Published:2021-06-17
Contact: DAI Fu,Email:hfsdf@sina.com;ZHENG Ji-shun,Email:zhengjishun1@163.com

摘要/Abstract

摘要： 目的探究简化版动物命名实验(S-ANT)对轻微肝性脑病(MHE)诊断的应用价值。方法选取2018年8月至2020年6月安徽医科大学第三附属医院消化科及感染科住院确诊肝硬化患者149例,入院48 h内完成基本信息和实验室指标收集,应用 Child-Pugh评分将患者分为 A、B、C3级,同期选取149名体检者为健康对照组,以神经心理学测试(PHES)为金标准,分别采用PHES和简化版动物命名实验(S-ANT)筛查MHE患病率。结果使用S-ANT筛查时有61例(40.94%)肝硬化患者合并MHE;S-ANT在MHE患者中最低为(13.82±4.54),其次是1级肝性脑病(HE)患者(14.33±2.94)、无隐匿性肝性脑病(CHE)患者(18.99±4.61)和健康对照组(24.98±5.64),各组之间比较,差异有统计学意义(P<0.05)。S-ANT<17是诊断MHE的最佳截断值,诊断MHE灵敏度为80.3%,特异度为67.0%,阳性预测值为81.82%,阴性预测值为72.06%。结论 S-ANT是诊断MHE的一种更为简便有效的方法。

关键词: 轻微肝性脑病, 神经心理学测试, 动物命名实验

Abstract: Objective To explore the application value of the simplified animal naming experiment (S-ANT) in the diagnosis of minimal hepatic encephalopathy (MHE).Methods 149 patients with liver cirrhosis who were hospitalized from August 2018 to June 2020 were selected as the experimental group. The basic information and laboratory indicators of these patients were collected within 48 hours after admission. The patients were divided into A, B, and C groups based on their Child -Pugh gradings. At the same time, 149 healthy medical examiners were selected as the control group. The Psychometric Hepatic Encephalopathy Score Test (PHES) was used as the gold standard for diagnosing MHE. The simplified animal naming experiment (S-ANT) were compared with PHES for screening the prevalence of MHE. Results By S-ANT screening 61 (40.94%) patients with liver cirrhosis were identified to complicate with MHE; The S-ANT score was the lowest among MHE patients (13.82±4.54), followed by grade 1 hepatic encephalopathy (HE) patients (14.33±2.94), patients without chronic hepatic encephalopathy (non-CHE) (18.99±4.61) and healthy control group (24.98±5.64), the comparison between the groups is statistically significant (P<0.05); S-ANT<17 is the best cut-off value for the diagnosis of MHE with a sensitivity of 80.3%, specificity of 67.0%, positive predictive value of 81.82%, and negative predictive value of 72.06%.Conclusion S-ANT is a more convenient and effective method for diagnosing MHE.

Key words: Minimal hepatic encephalopathy, Psychometric Hepatic Encephalopathy Score Test, Animal naming experiment

王娜, 戴夫, 郑吉顺, 彭琼, 徐鹤翔, 陈利雪. 简化版动物命名实验对轻微肝性脑病的诊断作用[J]. 肝脏, 2021, 26(5): 494-496.

WANG Na, DAI Fu, ZHENG Ji-shun, PENG Qiong, XU He-xiang, CHEN Li-xue. Diagnosis performance of simplified animal naming experiment on minimal hepatic encephalopathy[J]. Chinese Hepatolgy, 2021, 26(5): 494-496.

参考文献

[1] 中华医学会消化病学分会,中华医学会肝病学分会.中国肝性脑病诊治共识意见( 2013 年,重庆) [J/CD].中国医学前沿杂志:电子版,2014,6: 81-93.
[2] Li SW, Wang K, Yu YQ,et al.Psychometric hepatic encephalopathy score for diagnosis of minimal hepatic encephalopathy in China.World J Gastroenterol, 2013,19: 8745-8751.
[3] Lin Y, Fan YP. The neuropsychologic tests and the minimal hepatic encephalopathy investigations in liver cirrhotic patients. Zhonghua Gan Zang Bing Za Zhi, 2011,19:65-66.
[4] Campagna F, Montagnese S, Ridola L, et al. The animal naming test: an easy tool for the assessment of hepatic encephalopathy. Hepatology, 2017,66:198-208.
[5] 中华医学会传染病与寄生虫病学分会、肝病学分会.病毒性肝炎防治方案.中华肝脏病杂志,2000,8:324-329.
[6] Dhiman RK, Saraswat VA, Sharma BK, et al. Minimal hepatic encephalopathy: consensus statement of a working party of the Indian National Association for Study of the Liver. J Gastroenterol Hepatol, 2010,25:1029-1041.
[7] Lauridsen MM, Thacker LR, White MB, et al. In patients with cirrhosis, driving simulator performance is associated with real-life driving. Clin Gastroenterol Hepatol, 2016,14:747-752.
[8] Ferenci P. Hepatic encephalopathy. Gastroenterol Rep (Oxf),2017,5: 138-147.
[9] Wang JY, Zhang NP, Chi BR, et al. Prevalence of minimal hepatic encephalopathy and quality of life evaluations in hospitalized cirrhotic patients in China. World J Gastroenterol, 2013,19:4984-4991.
[10] Bajaj JS, Cordoba J, Mullen KD, et al. Review article: the design of clinical trials in hepatic encephalopathy—an international society for hepatic encephalopathy and nitrogen metabolism (ISHEN) consensus statement. Aliment Pharmacol Ther, 2011,33:739-747.
[11] Coskun B, Ozen M, Gursoy S, et al. Normalization of the psychometric hepatic encephalopathy score for diagnosis of minimal hepatic encephalopathy in Turkey. Niger J Clin Pract, 2017,20:421-426.
[12] Metwally MA, Biomy HA, Omar MZ, Sakr AI. Critical flickering frequency test: a diagnostic tool for minimal hepatic encephalopathy. Eur J Gastroenterol Hepatol, 2019,31:1030-1034.
[13] Bajaj JS, Fagan A, White MB, et al. Specific gut and salivary microbiota patterns are linked with different cognitive testing strategies in minimal hepatic encephalopathy. Am J Gastroenterol, 2019,114:1080-1090.