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Screening for minimal hepatic encephalopathy in patients with cirrhosis by cirrhosis-related symptoms and a history of overt hepatic encephalopathy


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タイトル: Screening for minimal hepatic encephalopathy in patients with cirrhosis by cirrhosis-related symptoms and a history of overt hepatic encephalopathy
その他のタイトル: 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
著者: 吉村, 映美
著者(別表記) : Yoshimura, Emi
発行日: 2017年 2月22日
出版者: Spandidos Publications
引用: Nagasaki University (長崎大学), 博士(医学) (2017-02-22)
抄録: 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.
記述: 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
キーワード: overt hepatic encephalopathy history / minimal hepatic encephalopathy / cirrhosis / cirrhosis‑related symptom score
URI: http://hdl.handle.net/10069/37061
ISSN: 20499434
DOI: 10.3892/br.2016.702
権利: (C) 2016 Spandidos Publications
資料タイプ: Thesis or Dissertation
原稿種類: ETD
出現コレクション:110 学位論文

引用URI : http://hdl.handle.net/10069/37061

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