Pathophysiology, diagnosis, and management of hepatic encephalopathy

被引：10
作者：
Sheasgreen, Christopher [1 ]
Lu, Lucy [1 ]
Patel, Ameen [1 ]
机构：
[1] McMaster Univ, Dept Med, Hamilton, ON, Canada
来源：
INFLAMMOPHARMACOLOGY | 2014年 / 22卷 / 06期
关键词：
Hepatic encephalopathy; Ammonia; Lactulose; Antibiotics; PORTAL-SYSTEMIC ENCEPHALOPATHY; RANDOMIZED CONTROLLED-TRIAL; NECROSIS-FACTOR-ALPHA; DOUBLE-BLIND; LIVER-DISEASE; CIRRHOTIC-PATIENTS; ALBUMIN DIALYSIS; AMMONIA LEVELS; SECONDARY PROPHYLAXIS; NITROGEN-METABOLISM;
D O I：
10.1007/s10787-014-0217-9
中图分类号：
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号：
100102 ;
摘要：
Hepatic encephalopathy (HE) is a common complication of cirrhosis of the liver. It is also extremely debilitating, with an untreated 3-year survival of only 23 %. While the exact pathophysiology of HE has yet to be elucidated, a number of contributing factors have been described. Abnormal levels and altered metabolism of ammonia play a central role. Recently, inflammation has also been identified as a contributor to HE. Improved understanding of the pathophysiology of HE is crucial, as current therapy centers on reduction of the body's ammonia load. Lactulose is the first-line therapy for HE, with some antibiotics recently showing promise for improved outcomes in patients with HE. The role of anti-inflammatory therapies has yet to be evaluated.
引用
收藏
页码：319 / 326
页数：8
相关论文
共 71 条
  • [11] AMMONIA - KEY FACTOR IN THE PATHOGENESIS OF HEPATIC-ENCEPHALOPATHY
    BUTTERWORTH, RF
    GIGUERE, JF
    MICHAUD, J
    LAVOIE, J
    LAYRARGUES, GP
    [J]. NEUROCHEMICAL PATHOLOGY, 1987, 6 (1-2): : 1 - 12
  • [12] Hyperammonemia in the ICU
    Clay, Alison S.
    Hainline, Bryan E.
    [J]. CHEST, 2007, 132 (04) : 1368 - 1378
  • [13] CONN HO, 1977, GASTROENTEROLOGY, V72, P573
  • [14] Normal protein diet for episodic hepatic encephalopathy:: results of a randomized study
    Córdoba, J
    López-Hellín, J
    Planas, M
    Sabín, P
    Sanpedro, F
    Castro, F
    Esteban, R
    Guardia, J
    [J]. JOURNAL OF HEPATOLOGY, 2004, 41 (01) : 38 - 43
  • [15] Hepatic encephalopathy is associated with decreased cerebral oxygen metabolism and blood flow, not increased ammonia uptake
    Dam, Gitte
    Keiding, Susanne
    Munk, Ole L.
    Ott, Peter
    Vilstrup, Hendrik
    Bak, Lasse K.
    Waagepetersen, Helle S.
    Schousboe, Arne
    Sorensen, Michael
    [J]. HEPATOLOGY, 2013, 57 (01) : 258 - 265
  • [16] DAWSON AM, 1957, LANCET, V2, P1263
  • [17] Secretion of interleukin-1β by astrocytes mediates endothelin-1 and tumour necrosis factor-α effects on human brain microvascular endothelial cell permeability
    Didier, N
    Romero, IA
    Créminon, C
    Wijkhuisen, A
    Grassi, J
    Mabondzo, A
    [J]. JOURNAL OF NEUROCHEMISTRY, 2003, 86 (01) : 246 - 254
  • [18] Contribution of hyperammonemia and inflammatory factors to cognitive impairment in minimal hepatic encephalopathy
    Felipo, Vicente
    Urios, Amparo
    Montesinos, Encarna
    Molina, Inmaculada
    Garcia-Torres, Maria L.
    Civera, Miguel
    Del Olmo, Juan A.
    Ortega, Joaquin
    Martinez-Valls, Jose
    Serra, Miguel A.
    Cassinello, Norberto
    Wassel, Abdallah
    Jorda, Esperanza
    Montoliu, Carmina
    [J]. METABOLIC BRAIN DISEASE, 2012, 27 (01) : 51 - 58
  • [19] Newer approaches to therapy of hepatic encephalopathy
    Ferenci, P
    Herneth, A
    Steindl, P
    [J]. SEMINARS IN LIVER DISEASE, 1996, 16 (03) : 329 - 338
  • [20] Hepatic encephalopathy-definition, nomenclature, diagnosis, and quantification: Final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998
    Ferenci, P
    Lockwood, A
    Mullen, K
    Tarter, R
    Weissenborn, K
    Blei, AT
    [J]. HEPATOLOGY, 2002, 35 (03) : 716 - 721
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