Ferenci P, Csomós G
4. sz. Belgyógyászati Klinika, Hepatológiai és Gasztroenterológiai Osztály, Bécs.
Orv Hetil. 1993 Feb 14;134(7):339-44.
The syndrome of hepatic encephalopathy includes all the neuropsychiatric changes which appear in acute and chronic liver diseases. To understand the pathophysiology of hepatic encephalopathy, it would be essential to accurately study cerebral activity in human, but it is impossible at present. Animal models of acute hepatic encephalopathy available at present, reproduce just a narrow aspect of the human disease. Moreover, there is no useful animal model for chronic hepatic encephalopathy. Therefore, the exact pathophysiology of hepatic encephalopathy in human, is yet unknown. Theoretically, the disturbance of cerebral activity can be explained by the altered permeability of the blood-brain-barrier, the accumulation of neurotoxins, disturbance of neurotransmission by the altered substrate-supply, or by the disturbance of energy-balance. This review summarize those possible pathomechanisms, which are playing--in our present knowledge--important role in the development of hepatic encephalopathy.
肝性脑病综合征包括急性和慢性肝病中出现的所有神经精神变化。要了解肝性脑病的病理生理学，准确研究人类大脑活动至关重要，但目前尚无法做到。目前可用的急性肝性脑病动物模型仅再现了人类疾病的一个狭窄方面。此外，尚无用于慢性肝性脑病的有用动物模型。因此，人类肝性脑病的确切病理生理学尚不清楚。从理论上讲，大脑活动的紊乱可以通过血脑屏障通透性改变、神经毒素积累、底物供应改变导致的神经传递紊乱或能量平衡紊乱来解释。本综述总结了那些可能的发病机制，就我们目前的认知而言，这些机制在肝性脑病的发展中起着重要作用。
