Badea M A, Prelipcean Cristina Cijevschi, Mihai Catalina, Drug V
Rev Med Chir Soc Med Nat Iasi. 2015 Jan-Mar;119(1):9-17.
Minimal hepatic encephalopathy (MHE) defines the presence of neurocognitive impairments in patients with cirrhosis or portal-systemic shunting that show a normal neurologic and psychiatric status on clinical examination. Although ammonia has the central role in MHE pathogenesis, factors such as infection, oxidative stress, manganese or intestinal bacterial overgrowth contribute to the development of the neurocognitive deficits associated with this disease. Many methods have proven useful in identifying MHE but because of the major drawbacks (standardization requirements, high price, sophisticated equipment, and limited access) a gold-standard test is still missing. Although beneficial, the treatment of MHE is not routinely recommended and should be taken into consideration in patients at risk for accidents and in those with cognitive complaints or decline in work performance.
轻微肝性脑病（MHE）指的是肝硬化或门体分流患者存在神经认知障碍，但临床检查显示其神经和精神状态正常。尽管氨在MHE发病机制中起核心作用，但感染、氧化应激、锰或肠道细菌过度生长等因素也会导致与该疾病相关的神经认知缺陷的发展。许多方法已被证明对识别MHE有用，但由于存在主要缺点（标准化要求、价格高昂、设备复杂且获取受限），目前仍缺乏金标准检测方法。尽管MHE治疗有益，但通常不建议常规进行，对于有事故风险的患者以及有认知主诉或工作表现下降的患者应予以考虑。
