6项用于诊断最小肝脑病变和预测临床结果的测试的比较:一项前性观察性研究
Alena F Ehrenbauer1,2, Julius F M Egge1,2, Maria M Gabriel1
1Department of Neurology, Hannover Medical School, Hannover, Germany.
Hepatology (Baltimore, Md.)
|February 13, 2024
概括
在肝硬化患者中诊断最小的肝脑病变 (HE) 是至关重要的. 虽然存在几种测试,但只有心理测量肝脏脑病变得分 (PHES) 显示了明显的HE发展的预测价值.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 神经学 神经学
- 临床诊断 临床诊断 临床诊断
背景情况:
- 目前的指导方针强调在肝硬化患者中进行最小的肝脑病 (HE) 评估.
- 开发最小的HE简化诊断工具是一个正在进行的研究领域.
研究的目的:
- 为了比较六个常见的诊断测试的有效性和预测价值,最小的HE.
- 评估这些测试对明显的HE,再住院和肝硬化患者的死亡率的预测能力.
主要方法:
- 一百三十二名肝硬化患者使用六种测试进行了评估:PHES,ANT,CFF,ICT,Stroop (EncephalApp) 和CRT.
- 患者在365天内被监测到明显的HE,再入院和死亡.
- 测试结果使用固定切断值和调整后的正常值进行分析.
主要成果:
- 在神经不受损的患者中,使用Stroop,ANT,ICT和CFF的调整规范与固定截止值时,异常率有显著的变化.
- 在随访期间,异常的心理测量肝脏脑病变评分 (PHES) 结果与明显的HE的发展有显著的关联.
- 没有其他经过测试的方法证明了公开的HE,再住院或在多变量调整后死亡的预测价值.
结论:
- 最小的HE诊断应该完全依赖于测试的调整的正常值.
- 评估的最小HE测试是不可互换的,对临床结果的预测能力有限.
相关概念视频
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess the...
01:29Hepatic Encephalopathy
DefinitionHepatic encephalopathy is a reversible neurologic syndrome that results from advanced liver dysfunction or portosystemic shunting. It leads to disturbances in cognition, behavior, and motor function due to the brain’s exposure to gut-derived toxins that the liver fails to detoxify.EtiologyThis condition develops either in the setting of acute fulminant hepatitis or progressively during chronic liver disease, such as cirrhosis and portal hypertension. Portosystemic shunting—including...