並列タイトル等肝硬変に伴う症状と顕性脳症による肝硬変患者におけるミニマル脳症のスクリーニング
授与機関名Nagasaki University (長崎大学)
一般注記The diagnosis of minimal hepatic encephalopathy (MHE) is more difficult in comparison to the diagnosis of overt hepatic encephalopathy (OHE), as patients with MHE do not exhibit overt neurological deficits and must be diagnosed using specialized equipment. However, identifying MHE is critical for patients with cirrhosis, and a simple screening test is required. The present study aimed to evaluate the associations between MHE, clinical characteristics and questionnaire items regarding sleep disturbances and cirrhosis?related symptom score (CSS). A total of 91 patients who had cirrhosis without OHE were evaluated using various questionnaires [i.e., CSS, Epworth Sleepiness Scale, the Japanese version of the Pittsburgh Sleep Quality Index (PSQI) and the Japanese 36?item short?form health survey (SF?36)]. MHE was diagnosed using the neuropsychological test. MHE was associated with severe liver damage, which was indicated by liver damage markers and a history of OHE. In addition, MHE was associated with the CSS, PSQI and SF?36 results. The multivariate analyses revealed that a history of OHE was the factor that was the most strongly associated with MHE. Among patients without a history of OHE, MHE was most strongly associated with CSS, although it was also associated with severe liver damage and platelet counts. A prediction score (calculated using a history of OHE and CSS) provided an area under the receiver operating characteristic curve of 0.738 and a sensitivity of 0.671 for identifying MHE. In conclusion, a history of OHE and CSS may be useful for identifying MHE in patients with cirrhosis.
長崎大学学位論文 学位記番号:博(医歯薬)甲第926号 学位授与年月日:平成29年2月22日
Author: Emi Yoshimura, Tatsuki Ichikawa, Hisamitsu Miyaaki, Naota Taura, Satoshi Miuma, Hidataka Shibata, Takuya Honda, Fuminao Takeshima, Kazuhiko Nakao
Citation: Biomedical Reports, 5(2), pp.193-198; 2016
Nagasaki University (長崎大学), 博士(医学) (2017-02-22)
DOIinfo:doi/10.3892/br.2016.702
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