| Objective The purpose of the present study was to investigate the cognition and its attribution of patients with chronic HBV infection by using Revised Illness Perception Questionnaire (IPQ-R), and to provide scientific bases and sensitive detection methods for the diagnosis of subclinical hepatic encephalopathy(SHE).Methods 87 patients with chronic HBV infection were invited to complet the IPQ-R. Data were analysed using covariance structure analysis. The Neuropsychological Test Battery (HKU-AHMU Battery) was organized by Cognitive Neuroscience Laboratory of Anhui Medical University and Clinical Psychology Institute of HongKong University, by which 26 liver cirrhosis (LC) and 75 healthy people were tested. The study was composed of attention tests, memory tests, visual and spatial perception about the prefrontal fluency, et al. There were digital span test, balloon test, color trails test, symbol digital modalities test, sigital vigilance test and stroop test in attention, and Chinese auditory learning test, ruff-light learning test in memory. The visual trabecular spaces consisted of hooper visual organization test and judgment of line orientation test. Prefrontal fluency contained verbal and figure fluency test. Each testee was required to complete continuously by the same tester in 1.5-2 hours.Results The validity of the cognitive factors on the overall scale and the reliability among them were statistically significant (P<0.05). There was no correlation between illness identity and other illness factors, such as emotional representation, timeline cyclical and timeline-acute/chronic, et al. Illness coherence was significant negative correlation to personal control, treatment control, but was positive to timeline cyclical and emotional representation. Treatment control was negative correlation to timeline cyclical, and that consequences was positive to timeline-acute/chronic, timeline cyclical and emotional representation. Other cognition factors were no correlation to clinical spectra except timeline cyclical (P<0.05), so same as to clinical course except illness coherence(P<0.01). Gender and education degree had no effect on the cognition factors of chronic HBV infection (P>0.05). 18 pathogenic factors could be summarized as psychological stress, behavioral and biological factors, each of which has correlation to some of the cognition factors. Compared with diabetes, the patients with chronic HBV infection had significantly higher scores on cognitive tests (P<0.05). The results of liver cirrhosis were worse than the normal group (P<0.05) in Hooper Visual Organization Test, Judgment of Line Orientation Test, Digital Span Test, Balloon Test, Color Trails Test, Symbol Digital Modalities Test, Stroop Test, Chinese Auditory Learning Test, Ruff-light Learning Test, some of which had closely related to Child grades such as Symbol Digital Modalities Test, Hooper Visual Organization Test, Chinese Auditory Learning Test, Judgment of Line Orientation Test. That is, the more severe the disease cirrhosis, the poorer the results of these four tests. The abnormal results in neuropsychological tests of Cirrhosis group were not correlated with age (P>0.05). Line judge the direction of test, Stroop points and words test were correlated to education degree (P<0.05).Conclusion The patients with chronic HBV infection had negative perception excessively about illness, Especially CHB;patients'of Chronic HBV infection have similar diseases attributed with other chronic diseases; Sex and educational level of patients' have no effect on cognition , marital status may change their personal control. The high-level neural function on attention, memory, visual and spatial perception about the prefrontal fluency has apparent dysfunction of SHE. HKU-AHMU Battery can be adapted to assistant diagnoses with SHE because of its sensitivity. |
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