Electroencephalography In Patients With Mild Hepatic Encephalopathy Associated With Clinically Relevant Indicators

Hepatic encephalopathy(HE) is a complicated nerve spirit syndrome, clinically, for cognitive impairment、behavior disorders and dysfunction,its associated with liver failure and/or the hydrodynamic venous shunt,main show is disturbance of consciousness, behavior disorders and coma. HE is serious and fatal complications of acute and chronic liver disease, If not timely correcting, and even life-threatening.The pathogenesis of hepatic encephalopathy is currently accepted theory of ammonia poisoning, the formation and metabolic of blood ammonia decided the progression of hepatic encephalopathy, Treatment is mainly to remove HE incentives and drop of blood ammonia treatment, etc, to achieve clinical cure.According to the patients’ mental state, clinical indexes and the change of the general state of consciousness, HE can be divided into 0 to 4 five times(west Haven stage), that is, from minimal mental change to deep coma, where 0 is the MHE, MHE refers to patients with cirrhosis of the liver in the clinical examination without exception, but appear nervous psychology and injury of nerve physiology, if MHE not timely intervention and treatment, could eventually develop into OHE. OHE is not difficult clinically by symptoms, signs and laboratory diagnosis, MHE is easy to misdiagnosis and missed diagnosis because there was no nervous system performance. MHE has not yet a unified diagnostic criteria, need high sensitivity and strong specificity of clinical diagnostic method, MHE due to lack of typical clinical manifestations, only through neural physiological and neuropsychological test found that but will be affected by age, education level, learning and memory, and the influence of different cultural background, race, and the patient cooperation, should not be alone as a means of MHE screening. In order to solve these shortcomings, Van der Rijt put forward by the EEG spectrum analysis, and the first points out that the spectral analysis can be used as a diagnostic and prognostic indicators of hepatic encephalopathy, because EEG is not affected by the complexity of education and culture, and is not affected by psychological assessment and patient cooperation or not, EEG has been shown to be sensitive, independent HE monitoring tools.Object: To explore the clinical value of EEG examination in patients with mild hepatic encephalopathy.Materials and methods: Making inspection of EEG to 41 patients with mild hepatic encephalopathy,In order to observe EEG monitoring sensitivity and specificity of HE. 41 patients with mild hepatic encephalopathy in liver function Child – pugh classification is divided into A, B, C three groups; And according to the presence of HE typical clinical signs are divided into two groups; According to clinically relevant indicators divided into 5 groups, respectively with corresponding EEG were analyzed. Results:(1) The causes of mild hepatic encephalopathy in liver cirrhosis with 36 cases, accounting for 87.80%;(2) 41 cases of abnormal EEG in patients with minimal hepatic encephalopathy in 9 cases(21.95%), mild abnormality in 27 cases(65.85%), moderately abnormal in 5 cases(12.20%);(3) 41 cases of patients with mild hepatic encephalopathy according to the liver function Child-pugh classification is divided into three groups A, B, C, 8 cases of group A and group B 12 cases, 21 cases of group C, there was no significant differences between group B and group C, there are significant differences between group A and group B,group A and group C;(4) AST/ALT ratio≥1.2 group and<1.2 group there was no significant difference comparing abnormal EEG; Total bilirubin acuities≤34.2 and >34.2 group there was no significant difference comparing abnormal EEG; Albumin > 30 and ≤ 30 group have significant difference comparing EEG anomalies, including minimal abnormal EEG and mild abnormal EEG have significant difference;(5) The PTA >80 group and ≤80 group, the PTA >40 group and ≤40 group there is no significant difference comparing abnormal EEG;(6) Blood ammonia≥60 group and <60 group there was no significant difference comparing abnormal EEG; Blood ammonia≥120 group and < 120 group there is no significant difference comparing abnormal EEG;(7) There are significant differences between the groups with and without HE clinical signs, including the abnormal EEG of mild HE has significant difference compared with that of MHE. Conclusion:(1)Patients with minimal hepatic encephalopathy can appear minimal EEG waves;(2) EEG abnormality degree were positively correlated with hepatic encephalopathy grading;(3)EEG examination has strong practicability, easy operation etc, can be used as a tool of clinical diagnosis of mild hepatic encephalopathy, can be more widely used in clinic, increase the mild hepatic encephalopathy, especially the diagnosis of minimal hepatic encephalopathy.