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斯特鲁普测试对轻微性肝性脑病的诊断价值

王腾 朱伊静 赵守松

引用本文:
Citation:

斯特鲁普测试对轻微性肝性脑病的诊断价值

DOI: 10.3969/j.issn.1001-5256.2022.04.017
伦理学声明:本研究方案于2021年2月1日经由蚌埠医学院第一附属医院伦理委员会审批,批号:2021KY006。
利益冲突声明:本研究不存在研究者、伦理委员会成员、受试者监护人以及与公开研究成果有关的利益冲突。
作者贡献声明:王腾负责设计研究方案,设计论文框架,统计分析,撰写论文;朱伊静负责实施研究过程,采集整理数据;赵守松负责提出研究选题,修订论文,确定研究方案并提供指导性支持。
详细信息
    通信作者:

    赵守松, 1260345655@qq.com

Value of Stroop test in the diagnosis of minimal hepatic encephalopathy

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    Corresponding author: ZHAO Shousong, 1260345655@qq.com (ORCID: 0000-0002-8076-518X)
  • 摘要:   目的  探讨神经心理学测试——斯特鲁普(Stroop)测试对轻微性肝性脑病(MHE)的诊断价值。  方法  选取2020年8月-2021年3月于蚌埠医学院第一附属医院感染性疾病科住院治疗的96例肝硬化患者, 进行数字连接试验A(NCT-A)、数字符号试验(DST)、动物命名试验(ANT)及Stroop测试, 记录测试结果并收集临床数据。正态分布的计量资料组间比较采用t检验; 非正态分布的计量资料2组间比较采用Mann-Whitney U检验。计数资料组间比较采用χ2检验。采用ROC曲线评价Stroop测试对MHE的诊断价值, Pearson相关系数分析Stroop测试结果与NCT-A、DST、ANT的相关性。  结果  96例肝硬化患者中, MHE患病率为30.21%(29/96)。Stroop测试的Off+On总时间诊断MHE时的截断值为212.49 s, 其AUC为0.845, 敏感度为93.10%, 特异度为64.20%。Pearson相关系数分析结果显示, Stroop测试结果中的On+Off时长、On时长与NCT-A呈中等相关(r值分别为0.580、0.590, P值均 < 0.01), Off时长与NCT-A呈强相关(r=0.620, P < 0.01);On+Off时长、On时长、Off时长与DST均呈强相关(r值分别为-0.650、-0.650、0.630, P值均 < 0.01)。  结论  在诊断MHE中, Stroop测试是一项敏感度高、无需专业设备、结果易读、诊断价值高的方法。

     

  • 图  1  Stroop测试、NCT-A、DST和ANT用于肝硬化MHE诊断的ROC曲线

    Figure  1.  ROC curve of Stroop test, NCT-A, DST and ANT for MHE diagnosis

    表  1  MHE患者与无MHE患者一般资料比较

    Table  1.   Comparison of general data between patients with MHE and without MHE

    指标 MHE组(n=29) 无MHE组(n=67) 统计值 P
    年龄(岁) 52.07±7.91 46.34±9.30 t=2.891 0.005
    WBC(×109/L) 3.75(2.50~5.28) 4.21(3.16~6.24) Z=-1.540 0.124
    NEUT(×109/L) 2.20(1.41~2.78) 2.17(1.65~4.04) Z=-0.938 0.348
    RBC(×1012/L) 3.64±0.87 3.90±0.79 t=-1.475 0.144
    PLT(×109/L) 74.50(48.50~111.25) 95.00(56.00~153.00) Z=-1.313 0.189
    PT(s) 14.40(12.58~17.88) 13.60(12.30~16.00) Z=-1.217 0.223
    PTA(%) 68.18±19.60 74.17±18.74 t=-1.418 0.159
    FIB(g/L) 2.08(1.61~2.46) 2.22(1.58~3.03) Z=-0.682 0.495
    ALT(U/L) 29.00(19.25~55.00) 43.00(22.00~66.00) Z=-1.465 0.143
    AST(U/L) 40.00(28.75~87.50) 59.00(38.00~114.00) Z=-1.751 0.080
    ALP(U/L) 88.00(66.50~101.50) 110.00(77.00~160.00) Z=-2.326 0.020
    TBil(μmol/L) 23.80(19.65~43.28) 25.60(14.60~49.70) Z=-0.539 0.590
    Alb(g/L) 32.15±6.61 31.92±5.59 t=0.173 0.863
    SCr(μmol/L) 64.00(50.25~71.00) 61.00(51.00~69.00) Z=-0.419 0.675
    K+(mmol/L) 3.75±0.42 3.91±0.44 t=-1.639 0.105
    CRP(mg/L) 3.40(1.93~17.13) 6.40(2.30~28.70) Z=-0.950 0.342
    血浆氨 71.45±29.89 64.16±26.10 t=1.201 0.233
    MELD评分 12.00(8.25~14.75) 10.00(8.00~14.00) Z=-0.789 0.430
    下载: 导出CSV

    表  2  Stroop测试、NCT-A、DST和ANT对MHE诊断的ROC曲线结果

    Table  2.   ROC curve results of Stroop test, NCT-A, DST and ANT for MHE diagnosis

    指标 AUC 截断值 敏感度(%) 特异度(%)
    Off时长 0.837 110.62 s 82.80 73.10
    On时长 0.837 107.42 s 82.80 70.10
    Off+On时长 0.845 212.49 s 93.10 64.20
    ANT 0.065 14.50个 0 14.90
    NCT-A 0.788 58.61 s 89.70 58.20
    DST 0.172 29.50分 10.30 34.30
    下载: 导出CSV
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  • 收稿日期:  2021-08-25
  • 录用日期:  2021-10-09
  • 出版日期:  2022-04-20
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