Department of Gastroenterology, Hepatology and Infectious Diseases, Jagiellonian University Medical College, Sniadeckich Street 5, 31-531 Krakow, Poland.
Gastroenterol Res Pract. 2012;2012:642108. doi: 10.1155/2012/642108. Epub 2012 Dec 17.
Hepatic encephalopathy can be a serious complication of acute liver failure and chronic liver diseases, predominantly liver cirrhosis. Hyperammonemia plays the most important role in the pathogenesis of hepatic encephalopathy. The brain-blood barrier disturbances, changes in neurotransmission, neuroinflammation, oxidative stress, GABA-ergic or benzodiazepine pathway abnormalities, manganese neurotoxicity, brain energetic disturbances, and brain blood flow abnormalities are considered to be involved in the development of hepatic encephalopathy. The influence of small intestine bacterial overgrowth (SIBO) on the induction of minimal hepatic encephalopathy is recently emphasized. The aim of this paper is to present the current views on the pathogenesis of hepatic encephalopathy.
肝性脑病是急性肝衰竭和慢性肝病（主要是肝硬化）的严重并发症。血氨升高在肝性脑病的发病机制中起着最重要的作用。血脑屏障障碍、神经递质传递变化、神经炎症、氧化应激、GABA 能或苯二氮䓬途径异常、锰神经毒性、脑能量代谢紊乱和脑血流异常被认为与肝性脑病的发展有关。最近强调了小肠细菌过度生长（SIBO）对轻微肝性脑病的诱导作用。本文旨在介绍肝性脑病发病机制的最新观点。
