Clinical features and survivial of cirrhotic patients with subclinical cognitive alterations detected by the number connection test and computerized psychometric tests
Clinical features and survivial of cirrhotic patients with subclinical cognitive alterations detected by the number connection test and computerized psychometric tests
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DOI：
10.1002/hep.510290619
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发表时间：
1999-06-01
期刊：
影响因子：
13.5
通讯作者：
Gatta, A
中科院分区：
文献类型：
--
作者：
Amodio, P;Del Piccolo, F;Gatta, A
肝硬化患者亚临床认知改变的患病率和临床意义尚未得到很好的定义。因此，我们进行了一项研究，以评估肝硬化患者的临床特征和生存，通过数字连接测试（NCT）和一组计算机化心理测试（Scan， Choice1和Choice2）检测认知改变，测量执行特定任务的反应时间和错误百分比。94例无明显肝性脑病的肝硬化患者（年龄58 +/- 9岁）和80例对照组（年龄53 +/- 15岁）被连续纳入研究。肝硬化患者的中位随访时间为426天（下四分位数= 213天，上四分位数= 718天）。肝硬化患者的NCT扫描测试和Choice2测试结果明显较差，而Choice1与对照组无显著差异。在肝硬化患者中，NCT的心理测试改变率为21% (CI95% = 14%-31%)， Scan测试为23% (CI95% = 15%-33%)， Choice2测试为20% （CI95% = 16%-30%）。发现NCT、Scan和Choice2的改变与肝脏疾病的严重程度有关，而与病因无关。死亡风险增加与Scan试验改变（风险比= 2.4;CI95% = 1.1-5.3）或Choice2试验改变（风险比= 2.8;CI95% = 1.2-6.3）相关。多变量回归显示，在随访的第一年，除了Child-Pugh课程外，Scan和Choice2测试对生存有预后价值。
The prevalence and the clinical implications of subclinical cognitive alterations in cirrhotic patients have not been well defined as yet. Therefore, we performed a study to assess the clinical features and the survival of cirrhotic patients,vith cognitive alterations detected by the number connection test (NCT) and a set of computerized psychometric tests (Scan, Choice1, and Choice2) measuring the reaction times and the percentage of errors in performing specific tasks. Ninety-four cirrhotic patients (aged 58 +/- 9 years) without overt hepatic encephalopathy and 80 controls (aged 53 +/- 15 years) were consecutively enrolled. The median follow-up in cirrhotic patients was 426 days (lower quartile = 213 days; upper quartile = 718 days). Results of the NCT Scan test, and Choice2 test were significantly worse in cirrhotic patients, whereas Choice1 did not differ significantly from the controls. In cirrhotic patients, the prevalence of altered psychometric tests was 21% (CI95% = 14%-31%) by NCT, 23% (CI95% = 15%-33%) by Scan test, and 20% (CI95% = 16%-30%) by Choice2 test. The alterations of NCT, Scan, and Choice2 were found to be related to the severity of liver disease, independently of its etiology. Increased risk of death was found to be associated with altered Scan test (hazard ratio = 2.4; CI95% = 1.1-5.3), or altered Choice2 test (hazard ratio = 2.8; CI95% = 1.2-6.3). Multivariate regression showed that Scan and Choice2, tests had prognostic value on survival, in addition to Child-Pugh classes in the first year of follow-up.