Rothstein J D, Herlong H F
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Neurol Clin. 1989 Aug;7(3):563-78.
Neurologic complications of hepatic disease are not uncommon and involve the CNS more often than the peripheral nervous system or muscles. Progress in the therapy of neurologic disorders associated with hepatic failure has occurred in recent years. Notably, exciting developments in the treatment of hepatic encephalopathy with benzodiazepine antagonists will lead to a better understanding of the pathophysiology of this encephalopathy. The future use of these agents may eventually help reduce the morbidity and mortality of hepatic encephalopathy. The role of this class of drug in other metabolic encephalopathies remains to be established. Furthermore, new therapeutic and surgical alternatives to the treatment of Wilson disease also enhance our therapeutic options. The fate of patients with Wilson disease with fulminant hepatic disease and those patients unable to tolerate or unresponsive to penicillamine therapy has been greatly improved.
肝脏疾病的神经并发症并不少见，且累及中枢神经系统的情况比累及周围神经系统或肌肉更为常见。近年来，与肝衰竭相关的神经疾病治疗取得了进展。值得注意的是，苯二氮䓬拮抗剂治疗肝性脑病方面令人兴奋的进展将有助于更好地理解这种脑病的病理生理学。这类药物的未来应用最终可能有助于降低肝性脑病的发病率和死亡率。这类药物在其他代谢性脑病中的作用仍有待确定。此外，威尔逊病治疗的新疗法和手术替代方案也增加了我们的治疗选择。暴发性肝病的威尔逊病患者以及那些不能耐受青霉胺治疗或对其无反应的患者的预后已得到极大改善。
