Diagnostical value of methods for cognitive impairments assessing in patients with liver cirrhosis
- 作者: Galieva A.M.1, Mukhametova D.D.1, Belousova E.N.1, Khazieva G.R.1, Valitova A.D.1, Levanova P.I.2, Odintsova A.K.2, Abdulganieva D.I.1,2
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隶属关系:
- Kazan State Medical University of the Ministry of Healthcare of Russia
- Republican Clinical Hospital of the Ministry of Healthcare of the Republic of Tatarstan
- 期: 卷 10, 编号 5 (2024)
- 页面: 31-38
- 栏目: ORIGINAL STUDIES
- URL: https://journals.eco-vector.com/2412-4036/article/view/635061
- DOI: https://doi.org/10.18565/therapy.2024.5.31-38
- ID: 635061
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详细
Hepatic encephalopathy (HE) is the most common and serious complication of liver cirrhosis (LC). Its clinical picture can be varied – from minimal cognitive impairment to profound impairment of consciousness. There is no specific method for HE diagnosing.
The aim: to estimate the diagnostic value of tests used to evaluate HE in LC patients.
Material and methods. 86 LC patients hospitalized in gastroenterology department of Republican Clinical Hospital of the Ministry of Healthcare of the Republic of Tatarstan, Kazan were involved in the study. The average age of patients was 52 [43; 62] years, rate of females was 65%. For determination the stage of HE West – Haven criteria were used. The average MELD score was 14 [9; 20]. Number connecting test (NCT), MoCA scale, MMSE scale and blood ammonium level assessment were used in 84, 26, 28 and 45 patients, respectively.
Results. According to West – Haven criteria, 78 (90%) participants had HE: minimal HE – 22 (26%), stage 1 HE – 42 (50%), stage 2 HE – 14 (14%) persons. In 73 (87%) patients, the time required to perform NCT exceeded the norm. The average NCT value was 68 [49; 110.5] sec. Sensitivity of NCT for HE detecting was 93.4%, specificity – 75%, positive predictive value (PPV) – 97.3%. In 14 patients (54%), MoCA test scores were below normal, the average score was 25 [20; 28]. MoCA had a sensitivity for detecting HE of 63.6%, specificity of 100%, and PPV of 100%. In 20 patients (71%), the result on the MMSE test was below normal, the average score was 26.5 [24; 29]. The sensitivity of MMSE was 79.2%, specificity – 75%, PPV – 95%. 41 patients (91%) had elevated levels of ammonium in the blood, and 4 had normal levels. The average value of this indicator was 97 [66; 177] µmol/l. Sensitivity of blood ammonium determination for identifying HE was 90.24%, PPV – 90.24%.
Conclusion. NCT had the highest sensitivity for HE detecting, but its specificity was comparable to MMSE. MoCA had the highest specificity but low sensitivity. High sensitivity for HE detecting was also fixed for ammonium level determination.
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作者简介
Alsou Galieva
Kazan State Medical University of the Ministry of Healthcare of Russia
编辑信件的主要联系方式.
Email: alsou101@gmail.com
ORCID iD: 0000-0002-8026-6698
resident of the Department of hospital therapy, Kazan State Medical University of the Ministry of Healthcare of Russia
俄罗斯联邦, 420012, Kazan, 49 Butlerova St.Dilyara Mukhametova
Kazan State Medical University of the Ministry of Healthcare of Russia
Email: muhdilyara@gmail.com
ORCID iD: 0000-0003-2102-0142
MD, PhD (Medicine), assistant at the Department of hospital therapy, Kazan State Medical University of the Ministry of Healthcare of Russia
俄罗斯联邦, 420012, Kazan, 49 Butlerova St.Elena Belousova
Kazan State Medical University of the Ministry of Healthcare of Russia
Email: vanilla16@mail.ru
ORCID iD: 0000-0001-9369-4993
MD, PhD (Medicine), assistant at the Department of hospital therapy, Kazan State Medical University of the Ministry of Healthcare of Russia
俄罗斯联邦, 420012, Kazan, 49 Butlerova St.Gulshat Khazieva
Kazan State Medical University of the Ministry of Healthcare of Russia
Email: postgulshat@mail.ru
ORCID iD: 0009-0007-1006-8649
resident of the Department of hospital therapy, Kazan State Medical University of the Ministry of Healthcare of Russia
俄罗斯联邦, 420012, Kazan, 49 Butlerova St.Azalia Valitova
Kazan State Medical University of the Ministry of Healthcare of Russia
Email: azali1903@gmail.com
ORCID iD: 0000-0001-8980-5830
student of Kazan State Medical University of the Ministry of Healthcare of Russia
俄罗斯联邦, 420012, Kazan, 49 Butlerova St.Polina Levanova
Republican Clinical Hospital of the Ministry of Healthcare of the Republic of Tatarstan
Email: levanpi97@gmail.com
ORCID iD: 0009-0007-9257-9206
MD, gastroenterologist at the Department of gastroenterology
俄罗斯联邦, 420064, Kazan, 138 Orenburgsky TractAlfiya Odintsova
Republican Clinical Hospital of the Ministry of Healthcare of the Republic of Tatarstan
Email: odincovaa@yandex.ru
ORCID iD: 0000-0002-7148-8862
MD, PhD (Medicine), head of the Department of gastroenterology
俄罗斯联邦, 420064, Kazan, 138 Orenburgsky TractDiana Abdulganieva
Kazan State Medical University of the Ministry of Healthcare of Russia; Republican Clinical Hospital of the Ministry of Healthcare of the Republic of Tatarstan
Email: diana_s@mail.ru
ORCID iD: 0000-0001-7069-2725
MD, PhD (Medicine), head of the Department of hospital therapy
俄罗斯联邦, 420012, Kazan, 49 Butlerova St.; 420064, Kazan, 138 Orenburgsky Tract参考
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