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用含丰富支链氨基酸平衡液(BAS)治疗肿硬化肝性脑病是有效的。作者报告3例由急性病毒性肝炎所致的肝昏迷同样有效。一例于8小时内,两例均于12小时内清醒。治疗分别持续九、六和五天。急性病毒性肝炎所致的肝昏迷的予后是不良的。经一般治疗二度昏迷者病死率34％,四度昏迷者为85％。引起肝昏迷的生化变化还不清楚,1971年提出了一个新的假说:即肝昏迷的神经症状是由于假性神经介质所致。昏迷期间体内产生的小量多巴胺和去甲肾上腺素等正常神经介质为大量合成的假性神经介质如(?)胺和β苯基乙醇胺所代替。这些假性神经介质不能有效的刺激去甲肾上腺素受体。色氨酸量的增加,从而增加了昏迷的深度。在肝硬化和暴发性肺炎肝性脑病时,血清内芳香氨基酸(AAA)含量增加而支链氨基酸(BAA)含量降低或正常,这两组氨基酸竞争
Treatment of cirrhosis with hepatic encephalopathy is effective with rich branched-chain amino acids balance (BAS). The authors report that 3 cases of liver coma caused by acute viral hepatitis were equally effective. One case in 8 hours, two cases were awake within 12 hours. The treatment lasted nine, six and five days respectively. Postpartum hepatic coma caused by acute viral hepatitis is poor. After the general treatment of coma were 34% mortality, coma was 85%. Biochemical changes that cause hepatic coma are unclear. In 1971, a new hypothesis was proposed: the neurological symptoms of hepatic coma are due to the pseudo-neural mediators. A small amount of normal neurotransmitters such as dopamine and norepinephrine produced during the coma are replaced by a large number of synthetic pseudo-neural mediators such as (?) Amine and? Phenylethanolamine. These pseudo-neural mediators do not effectively stimulate norepinephrine receptors. Increase in the amount of tryptophan, thereby increasing the depth of coma. In cirrhotic and fulminant pneumonia with hepatic encephalopathy, the serum aromatase (AAA) content is increased and the content of branched-chain amino acids (BAA) is reduced or normal, both of which compete for amino acids