Advances in the diagnosis and treatment of hepatic encephalopathy
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摘要: 肝性脑病(HE)是在各种急慢性及终末期肝病的基础上出现的以代谢紊乱为主要特征的神经、精神、功能失调综合征。目前一致认为,由于氨中毒及感染使星型胶质细胞肿胀及脑水肿,从而导致这些症状的出现。然而,导致脑部形态学改变的细胞学机制尚未明确。我们可以通过多种方法来诊断及评估不同程度的HE。HE的治疗主要是去除诱因,同时根据有效的经验用药来明确诊断。HE的经验用药主要是使用利福昔明及乳果糖以减少肠道内氨的产生与吸收。
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关键词:
- 肝性脑病
Abstract: Hepatic encephalopathy (HE) is a serious neuropsychiatric complication of both acute and chronic liver disease.Symptoms of HE can include confusion, disorientation and poor coordination.A general consensus exists that the synergistic effects of excess ammonia and inflammation cause astrocyte swelling and cerebral edema;however, the precise molecular mechanisms that lead to these morphological changes in the brain are unclear.The best treatment to HE is to remove causes and to clarify the diagnosis through empiric therapy.Empiric therapy for HE is largely based on the principle of reducing the production and absorption of ammonia in the gut through administration of pharmacological agents such as rifaximin and lactulose.-
Key words:
- hepatic encephalopathy
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