Division of Hepatology, Baylor University Medical Center, Dallas, USA.
Curr Opin Gastroenterol. 2019 May;35(3):145-154. doi: 10.1097/MOG.0000000000000527.
Hepatic encephalopathy is one of the most debilitating clinical manifestations of cirrhosis and associated with increased morbidity and mortality. Treatment modalities available include the nonabsorbable disaccharides (lactulose) and the nonabsorbable antibiotics (rifaximin).
Newer therapeutic targets under evaluation include ammonia scavengers (ornithine phenylacetate) and modulation of gut microbiota (fecal microbiota transplantation).
This review will focus on the pathophysiology of hepatic encephalopathy along with an update on therapeutic targets under investigation.
肝性脑病是肝硬化最具危害性的临床表现之一,与发病率和死亡率的增加有关。现有的治疗方法包括不可吸收的双糖(乳果糖)和不可吸收的抗生素(利福昔明)。
正在评估的新的治疗靶点包括氨清除剂(苯乙酰鸟氨酸)和肠道微生物群的调节(粪便微生物群移植)。
本综述将重点介绍肝性脑病的病理生理学,并更新正在研究的治疗靶点。