Grover Vijay Pb, Tognarelli Joshua M, Massie Nicolas, Crossey Mary Me, Cook Nicola A, Taylor-Robinson Simon D
Liver Unit, Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, Imperial College London, London, UK.
Int J Gen Med. 2015 Dec 16;8:381-90. doi: 10.2147/IJGM.S86854. eCollection 2015.
Hepatic encephalopathy is a common neuropsychiatric abnormality, which complicates the course of patients with liver disease. It was probably first described by Hippocrates over 2000 years ago, who said that "those whose madness arises from phlegm are quiet and neither shout nor make a disturbance, while those whose madness arises from bile shout, play tricks and will not keep still, but are always up to some mischief ". He was presumably describing the differences between patients with pneumonia and acute liver failure. Despite the fact that the syndrome was probably first recognized thousands of years ago, the exact pathogenesis still remains unclear. Furthermore, a precise definition of the syndrome is lacking, as are definitive methods of diagnosing this condition. It is important as both patients with cirrhosis and the general population with whom they interact may be affected as a consequence. At a minimum, the individual may be affected by impaired quality of life, impaired ability to work, and slowed reaction times, which are relevant to the population at large if affected individuals operate heavy machinery or drive a car. Pathogenic mechanisms, diagnostic tools, and treatment options are discussed.
肝性脑病是一种常见的神经精神异常，它使肝病患者的病程复杂化。大约2000多年前，希波克拉底可能首次对其进行了描述，他说：“因痰而致疯癫的人安静，既不呼喊也不吵闹，而因胆汁而致疯癫的人呼喊、耍把戏且静不下来，总是在搞恶作剧”。他大概描述的是肺炎患者和急性肝衰竭患者之间的差异。尽管该综合征可能在数千年前就已被首次认识到，但其确切发病机制仍不清楚。此外，缺乏该综合征的确切定义以及诊断这种疾病的确定性方法。这很重要，因为肝硬化患者及其与之互动的普通人群都可能因此受到影响。至少，个体可能会受到生活质量受损、工作能力受损以及反应时间减慢的影响，如果受影响的个体操作重型机械或开车，这对广大人群也是相关的。本文将讨论其发病机制、诊断工具和治疗选择。
