肝性脑病的治疗进展

Progress in treatment of hepatic encephalopathy

肝性脑病(hepatic encephalopathy,HE)是严重肝病常见的并发症及死亡原因.临床上可表现为从不易察觉的,只有通过神经心理测试才能检测出的轻微性HE,到行为异常,智力减退,甚至昏迷,死亡.是一种可逆的神经精神障碍,不仅降低患者的生活质量,且因其具有复发的危险,导致患者频繁住院,由此产生的医疗费用也增加.不幸的是,HE的发病率持续升高,原因之一是部分病毒性肝炎患者如今已发展为肝硬化;原因之二是我们正处于全球肥胖的潮流中,代谢综合征与非酒精性脂肪肝的发病率增加,大多数患者出现慢性肝病相关的并发症,如HE.基于HE较高的发病率和死亡率及与之相关的医疗费用,寻求有效的治疗方法十分重要.本文将对HE治疗的进展作一概述.

Hepatic encephalopathy（HE） is a common com plication of severeliver diseaseanda common cause of mortality. Clinical features range from clinically imperceptiblesym ptomsinminim a lHE which require neuropsychological testing to identify, to abnormal behavior, mental deterioration, and even coma or death. It is a reversible progressive neuropsychiatric disorder that is associated with a decrease in quality of life and an increase in rate of hospitalization and consequent costs because patients are at risk for recurrence. Unfortunately, the prevalence of HE continues to rise for several reasons. For one, patients with viral hepatitis are now developing cirrhosis. Additionally, we are currently in the midst of a global obesity epidemic, which fuels the metabolic syndrome and nonalcoholic fatty liver disease, and these patients are now presenting in larger numbers with complications of chronic liver disease such as HE. The high morbidity and mortality com bined with the cost sunder line the importance to search the effective treatment for HE. This article reviews the progress in the treatment of HE.