背景：肝性脑病，（HE）虽然通常与肝硬化有关，在非肝硬化门静脉高压症（NCPH）中也有报道。在NCPH中识别和治疗HE的重要性在于许多患者可能被错误地诊断为患有精神病或神经系统疾病。因此，我们旨在系统回顾HE在NCPH中的患病率。
方法：对三个数据库的全面搜索(Medline，Embase和Scopus）从开始到2022年11月进行，以研究NCPH患者中最低HE（MHE）和明显HE（OHE）的患病率。结果以合并比例及其95%置信区间(CI)表示。
结果：筛选551条记录后，共纳入25项研究（n=1487）。NPCH中MHE的合并患病率为32.9％（95％CI：26.7-39.0），成年人之间无任何差异（32.9％，95%CI：23.5-42.3）和儿科患者（32.6%，95%CI：26.1-39.1）（p=0.941）。NCPH和代偿期肝硬化患者的患病率差异无统计学意义，比值比为1.06（95％CI：0.77-1.44）。NCPH中OHE既往史的合并事件率为1.2%(95%CI:0.3-2.1)。
结论：大约三分之一的NCPH患者有MHE，不论年龄组。OHE在NCPH中极为罕见，通常与沉淀因素有关。
Hepatic encephalopathy, (HE) although commonly associated with cirrhosis, has also been reported in non-cirrhotic portal hypertension (NCPH). The importance of identifying and treating HE in NCPH lies in the fact that many patients may be wrongly diagnosed as having psychiatric or neurologic disorders. Hence, we aimed to systematically
review the prevalence of HE in NCPH.
A comprehensive search of three databases (Medline, Embase and Scopus) was conducted from inception to November 2022 for studies reporting on the prevalence of minimal HE (MHE) and overt HE (OHE) in patients with NCPH. Results were presented as pooled proportions with their 95% confidence intervals (CI).
Total 25 studies (n = 1487) were included after screening 551 records. The pooled prevalence of MHE in NPCH was 32.9% (95% CI: 26.7-39.0) without any difference between adult (32.9%, 95% CI: 23.5-42.3) and pediatric patients (32.6%, 95% CI: 26.1-39.1) (p = 0.941). There was no significant difference in the prevalence between patients with NCPH and compensated cirrhosis with odds ratio of 1.06 (95% CI: 0.77-1.44). The pooled event rate for prior history of OHE in NCPH was 1.2% (95% CI: 0.3-2.1).
Around one-third of the patients with NCPH have MHE, irrespective of age group. OHE is extremely rare in NCPH and is usually associated with a precipitating factor.
