氨与肌肉：肝性脑病的新观点
Ammonia and the Muscle: An Emerging Point of View on Hepatic Encephalopathy.
作者信息
Di Cola Simone, Nardelli Silvia, Ridola Lorenzo, Gioia Stefania, Riggio Oliviero, Merli Manuela
机构信息
Department of Translational and Precision Medicine, Centre for the Diagnosis and Treatment of Portal Hypertension, "Sapienza" University of Rome, 00185 Rome, Italy.
出版信息
J Clin Med. 2022 Jan 26;11(3):611. doi: 10.3390/jcm11030611.
Abstract
In the last years the link between the presence of muscular alterations and hepatic encephalopathy (HE), both minimal and overt, has been deeply studied. The pathophysiological background supporting the relationship between muscle depletion, and HE is characterized by an imbalance between the capacity of muscle in ammonia metabolism and trafficking and the inability of the liver in removing ammonia through urea synthesis due to liver failure and/or the presence of porto-systemic shunts. This review will focus on the clinical burden, the physio pathological mechanisms understanding the liver muscle axis and principles of management of muscular alterations in cirrhosis.
摘要
在过去几年中，已经对轻度和明显的肌肉改变与肝性脑病（HE）之间的联系进行了深入研究。支持肌肉消耗与肝性脑病之间关系的病理生理背景的特征是，由于肝功能衰竭和/或存在门体分流，肌肉在氨代谢和转运方面的能力与肝脏通过尿素合成清除氨的能力之间存在失衡。本综述将重点关注临床负担、理解肝硬化中肝-肌肉轴的生理病理机制以及肌肉改变的管理原则。
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