中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 6
Jun.  2010

The new concepts on hepatic encephalopathy

  • Published Date: 2010-06-20
  • The consensus of hepatic encephalopathy (HE) has been newly published in China to be the supplement to the two national guidelines.According to 11th World Congresses of Gastroenterology (WCOG) proposed classification, type C encephalopathy is mostly seen in China.Moreover, a big portion of ALF is actually happened in HBV carriers for the large and sub-bulk hepatic necrosis.However, type A associated with acute liver failure (ALF) , is not rare, Brain MRI, CT, MRS, SPE-CT and PET-CT may provide useful information in diagnosis.Brain edema has been found to play an important role in the pathogenesis of HE, especially in patients with ALF.The new progress of pathogenetic mechanisms in brain edema include astrocyte swelling, extracellula glutamine change and disturbance of cerebral circulation, and the corresponding management are NAC treatment, tranquilizer, dehydration and hypothermia therapy.Intake of BCAA and protein should mainly depend on the types of HE.It has been proved BCAA reduce in ALF but increase in CLF, which implicate it's not suitable to supplement BCAA to the former but the latter.L-Ornithine-L-aspartate (OA) and nonabsorbable antibiotics and disaccharides are currently extensively used in HE, and L-Ornithine phenylacetate (OP) has potential value of application in HE.

     

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