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神经精神机能失调是肝硬化的一种严重并发症。其治疗对策是食用素食,限制动物蛋白质,服用乳果糖或乳山梨糖醇(Lnctitcl)。支链氨基酸对慢性肝性脑病的疗效尚不肯定。急性发作时常是用沉淀剂,禁食蛋白,灌肠剂,乳果糖和短疗程的新霉素控制。苯二氮(艹卓)类拮抗剂、正在研究中。 病因学 肝硬化患者可因肠源性,即结肠内细菌作用于蛋白质产生的有害物质引起脑中毒、毒性代谢产物可经门一体静脉吻合通道或因肝清除功能障碍而达脑内。目前对这些来源于肠道的毒性物质的本质还未弄清,通常认为氨是有害的,最近对暴发性肝炎的小鼠模型研究发现γ-氨基丁酸(GABA)
Neuropsychiatric disorders are a serious complication of cirrhosis. The treatment is to eat vegetarian, limiting animal protein, taking lactulose or lactositol (Lnctitcl). The effect of BCAA on chronic hepatic encephalopathy is uncertain. Acute attacks are often precipitated, fasting protein, enema, lactulose and short course of neomycin control. Benzodiazepines (antagonists) are currently under investigation. Etiology Patients with cirrhosis of the liver due to intestinalogenic, that is, bacteria in the colon caused by harmful substances in the brain lead to brain poisoning, toxic metabolites through the portal vein anastomosis or liver clearance due to dysfunction and brain. At present, the nature of these intestinal-derived toxic substances is unclear, and ammonia is generally considered harmful. Recent studies on fulminant hepatitis mouse models have found that GABA,