Rutgers New Jersey School of Medicine, 185 South Orange Avenue, MSB H-538, Newark, NJ 07103, USA.
Rutgers New Jersey School of Medicine, 185 South Orange Avenue, MSB H-538, Newark, NJ 07103, USA.
Clin Liver Dis. 2024 May;28(2):287-296. doi: 10.1016/j.cld.2024.01.006. Epub 2024 Feb 1.
Hepatic encephalopathy is a common cause of morbidity and mortality among patients with decompensated liver cirrhosis. In this article, we review the history, mechanism, and evidence for first-line pharmacologic therapies for hepatic encephalopathy including nonabsorbable disaccharides, antibiotics, and electrolyte management. We also review newer, second-line therapies including polyethylene glycol, albumin, branched-chain amino acids, probiotics and fecal microbiota transplant, zinc, and l-ornithine-l-aspartate.
肝性脑病是失代偿期肝硬化患者发病率和死亡率的常见原因。本文回顾了肝性脑病一线药物治疗的历史、机制和证据，包括不可吸收的双糖、抗生素和电解质管理。我们还回顾了更新的二线治疗方法，包括聚乙二醇、白蛋白、支链氨基酸、益生菌和粪便微生物移植、锌和左旋鸟氨酸-左旋门冬氨酸。
