Sivolap Yu P
Sechenov First Moscow State Medical University, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2017;117(10):144-147. doi: 10.17116/jnevro2017117101144-147.
Hepatic encephalopathy is a common neuropsychiatric complication of serious liver diseases and serves as a marker for worsening of their course and increasing the risk of death. The principal pathogenesis factors of hepatic encephalopathy is the excessive formation of ammonia and its accumulation by astrocytes. A key role in the prevention and treatment of hepatic encephalopathy is played by drugs that prevent hyperammonemia and promote the removal of ammonia from the body, namely lactulose, rifaximin and L-ornithine-L-aspartate. L-ornithine-L-aspartate has proven clinical effectiveness in the treatment of hepatic encephalopathy, prevents the transformation of minimal hepatic encephalopathy into overt forms, increases the tolerability of psychotropic drugs used in the treatment of alcohol dependence, and improves cognitive functions.
肝性脑病是严重肝脏疾病常见的神经精神并发症，是疾病进展恶化及死亡风险增加的标志。肝性脑病的主要发病机制是氨的过度生成及其被星形胶质细胞蓄积。预防和治疗肝性脑病的关键药物是能防止高氨血症并促进氨从体内清除的药物，即乳果糖、利福昔明和L-鸟氨酸-L-天冬氨酸。L-鸟氨酸-L-天冬氨酸已被证实对治疗肝性脑病具有临床疗效，可防止轻微肝性脑病转变为显性形式，提高用于治疗酒精依赖的精神药物的耐受性，并改善认知功能。
