脑电图监测肝性脑病的研究进展

安爽; 杨文轩; 张国山; 张泽天; 周鸿捷; 杨坤; 王守庆; 郭晓林

doi:10.3969/j.issn.1001-5256.2016.03.043

脑电图监测肝性脑病的研究进展

DOI: 10.3969/j.issn.1001-5256.2016.03.043

1. 吉林大学第一医院肝胆胰内科
2. 济南市中心医院消化内科

详细信息

中图分类号: R575.3
计量
- 文章访问数: 202
- HTML全文浏览量: 14
- PDF下载量: 126
- 被引次数: 0
出版历程
- 出版日期: 2016-03-20

Research advances in electroencephalographic monitoring of minimal hepatic encephalopathy

Department of Hepatology, The First Hospital of Jilin University

摘要

摘要: 肝性脑病(HE)是肝病晚期一种严重的神经心理并发症,是肝病患者死亡的主要原因之一。简述了HE分级、检查方法和脑电图(EEG)在HE诊断中的应用进展。认为EEG在HE领域得到了突破性发展,在HE的诊断、评估、预后和指导治疗等方面具有很大的潜力,但EEG监测HE的临床价值尚未得到医学界的认可,需要进一步的深入研究。
- 肝硬化 /
- 肝性恼病 /
- 脑电图 /
- 综述
Abstract: Hepatic encephalopathy( HE) is a serious neuropsychological complication in advanced liver disease,and is a major cause of death in patients with liver disease. The paper briefly introduces the advances in application of HE grading,examination methods,and electroencephalography( EEG) in the diagnosis of HE,and points out that EEG has been developed greatly in the field of HE,with huge potentials for the diagnosis,evaluation,prognosis,and guidance for treatment of HE. However,the clinical value of EEG monitoring in HE has not been widely acknowledged in the medical world,and further investigation is still needed in the future.
- liver cirrhosis /
- hepatic encephalopathy /
- electroencephalogram /
- review

HTML全文

参考文献(40)

[1]MARCHETTI P,D'AVANZO C,ORSATO R,et al.Electroencephalography in patients with cirrhosis[J].Gastroenterology,2011,141(5):1680-1689.

[2]OLESEN SS,GRAVERSEN C,HANSEN TM,et al.Spectral and dynamic electroencephalogram abnormalities are correlated to psychometric test performance in hepatic encephalopathy[J].Scand J Gastroenterol,2011,46(7-8):988-996.

[3]STEWART J,SARKELA M,KOIVUSALO AM,et al.Frontal electroencephalogram variables are associated with the outcome and stage of hepatic encephalopathy in acute liver failure[J].Liver Transpl,2014,20(10):1256-1265.

[4]BAJAJ JS,WADE JB,SANYAL AJ.Spectrum of neurocognitive impairment in cirrhosis:implications for the assessment of hepatic encephalopathy[J].Hepatology,2009,50(6):2014-2021.

[5]ZHAI HQ,FAN H,XUN LT.The advance of minimal hepatic encephalopathy[J].Chin J Gastroenterol Hepatol,2012,21(12):1158-1162.(in Chinese)翟慧勤,范红,寻琳婷.轻微肝性脑病的研究进展[J].胃肠病学和肝病学杂志,2012,21(12):1158-1162.

[6]SHARMA BC,SHARMA P,AGRAWAL A,et al.Secondary prophylaxis of hepatic encephalopathy:an open-label randomized controlled trial of lactulose versus placebo[J].Gastroenterology,2009,137(3):885-891.

[7]WIEST R,KRAG A,GERBES A.Spontaneous bacterial peritonitis:recent guidelines and beyond[J].Gut,2012,61(2):297-310.

[8]WUNSCH E,KOZIARSKA D,KOTARSKA K,et al.Normalization of the psychometric hepatic encephalopathy score in Polish population.A prospective,quantified electroencephalography study[J].Liver Int,2013,33(9):1332-1340.

[9]KHOR B,GARDET A,XAVIER RJ.Genetics and pathogenesis of inflammatory bowel disease[J].Nature,2011,474(7351):307-317.

[10]LEEVY CB,PHILLIPS JA.Hospitalizations during the use of rifaximin versus lactulose for the treatment of hepatic encephalopathy[J].Dig Dis Sci,2007,52(3):737-741.

[11]BAJAJ JS,SCHUBERT CM,HEUMAN DM,et al.Persistence of cognitive impairment after resolution of overt hepatic encephalopathy[J].Gastroenterology,2010,138(7):2332-2340.

[12]MARTINO ME,FERNNDEZ-LORENTE J,ROMERO-VIVES M,et al.Brain oscillatory activity during sleep shows unknown dysfunctions in early encephalopathy[J].J Physiol Biochem,2014,70(3):821-835.

[13]BAJAJ JS.Minimal hepatic encephalopathy matters in daily life[J].World J Gastroenterol,2008,14(23):3609-3615.

[14]DHIMAN RK,SARASWAT VA,SHARMA BK,et al.Minimal hepatic encephalopathy:consensus statement of a working party of the Indian National Association for Study of the Liver[J].J Gastroenterol Hepatol,2010,25(6):1029-1041.

[15]CAMPAGNA F,MONTAGNESE S,SCHIFF S,et al.Confounders in the detection of minimal hepatic encephalopathy:a neuropsychological and quantified EEG study[J].Liver Int,2015,35(5):1524-1532.

[16]JI F,SHANG GL,LIU Q.The failure of congnitive of subclinical hepatic encephalopathy[J].Chin J Nerv Ment Dis,2010,36(12):752-754.(in Chinese)季芳,尚桂莲,刘群.亚临床肝性脑病患者的认知障碍[J].中国神经精神疾病杂志,2010,36(12):752-754.

[17]AMODIO P,PELLEGRINI A,UBIALI E,et al.The EEG assessment of low-grade hepatic encephalopathy:comparison of an artificial neural network-expert system(ANNES)based evaluation with visual EEG readings and EEG spectral analysis[J].Clin Neurophysiol,2006,117(10):2243-2251.

[18]KHUNGAR V,POORDAD F.Hepatic encephalopathy[J].Clin Liver Dis,2012,16(2):301-320.

[19]KOZIARSKA D,WUNSCH E,MILKIEWICZ M,et al.Mini-Mental State Examination in patients with hepatic encephalopathy and liver cirrhosis:a prospective,quantified electroencephalography study[J].BMC Gastroenterol,2013,13:107.

[20]ROVIRA A,ALONAO J,CORDOBA J.MR imaging findings in hepatic encephalopathy[J].Am J Neuroradiol,2008,29(9):1612-1621.

[21]van der RIJT CC,SCHALM SW,de GROOT GH,et al.Objective measurement of hepatic encephalopathy by means of automated EEG analysis[J].Electroencephalogr Clin Neurophysiol,1984,57(5):423-426.

[22]NIEDERMEYER E,RIBEIRO M,HERTZ S.Mixed-type encephalopathies:preliminary considerations[J].Clin Electroencephalogr,1999,30(1):12-15.

[23]MLADENOVIC D,HRNCIC D,RASIC-MARKOVIC A,et al.Spectral analysis of thioacetamide-induced electroencephalographic changes in rats[J].Hum Exp Toxicol,2013,32(1):90-100.

[24]PARSONA-SMITH BG,SUMMERSKILL WH,DAWSON AM,et al.The electroencephalograph in liver disease[J].Lancet,1957,273(7001):867-871.

[25]BUTZ M,MAY ES,HUSSINGER D,et al.The slowed brain:cortical oscillatory activity in hepatic encephalopathy[J].Arch Biochem Biophys,2013,536(2):197-203.

[26]GOTZ T,HUONKER R,KRANCZIOCH C,et al.Impaired evoked and resting-state brain oscillations in patients with liver cirrhosis as revealed by magnetoencephalography[J].Neuroimage Clin,2013,13(2):873-882.

[27]BAJAJ JS.Current and future diagnosis of hepatic encephalopathy[J].Metab Brain Dis,2010,25(1):107-110.

[28]MONTAGNESE S,de RUI M,SCHIFF S,et al.Prognostic Benefit of the sddition of a quantitative index of hepatic encephalopathy to the MELD score:the MELD-EEG[J].Liver Int,2015,35(1):58-64.

[29]BABILONI C,VECCHIO F,DEL PERCIO C,et al.Resting state cortical electroencephalographic rhythms in covert hepatic encephalopathy and alzheimer’s disease[J].J Alzheimers Dis,2013,34(3):707-725.

[30] ZHANG XJ,CHENG JW,ZHANG LJ.Electroencephalographic analysis for patients with liver cirrhosis complicated by hepatic encephalopathy:an analysis of 62 cases[J].World Health Dig Med Period,2012,9(10):121-122.(in Chinese)张晓菁,程记伟,张利军.62例肝硬化合并肝性脑病患者脑电图分析[J].中外健康文摘,2012,9(10):121-122.

[31]SHAWCROSS DL,WRIGHT G,OLDE DAMINK SW,et al.Role of ammonia and inflammation in minimal hepatic encephalopathy[J].Metab Brain Dis,2007,22(1):125-138.

[32]ROMERO-GOMEZ M,JOVER M,DEL CAMPO JA,et al.Variations in the promoter region of the glutaminase gene and the development of hepatic encephalopathy in patients with cirrhosis:a cohort study[J].Ann Intern Med,2010,153(5):281-288.

[33]AHBOUCHA S.Neurosteroids and hepatic encephalopathy:an update on possible pathophysiologic mechanisms[J].Curr Mol Pharmacol,2011,4(1):1-13.

[34]GORG B,SCHLIESS F,HAUSSINGER D.Osmotic and oxidative/nitrosative stress in ammonia toxicity and hepatic encephalopathy[J].Arch Biochem Biophys,2013,536(2):158-163.

[35]LACHMANN V,GRG B,BIDMON HJ,et al.Precipitants of hepatic encephalopathy induce rapid astrocyte swelling in an oxidative stress dependent manner[J].Arch Biochem Biophys,2013,536(2):143-151.

[36]HAUSSINGER D,GORG B.Interaction of oxidative stress,astrocyte swelling and cerebral ammonia toxicity[J].Curr Opin Clin Nutr Metab Care,2010,13(1):87-92.

[37]HUNTER GR,YOUNG GB.Recovery of awareness after hyperacute hepatic encephalopathy with“flat”EEG,severe brain edema and deep coma[J].Neurocrit Care,2010,13(2):247-251.

[38]KAHLBROCK N,BUTZ M,MAY ES,et al.Lowered frequency and impaired modulation of gamma band oscillations in a bimodal attention task are associated with reduced critical flicker frequency[J].Neuroimage,2012,61(1):216-227.

[39] BAJAJ JS.Current and future diagnosis of hepatic encephalopathy[J].Metab Brain Dis,2010,25(1):107-110.

[40]GUERIT JM,AMANTINI A,FISCHER C,et al.Neurophysiological investigations of hepatic encephalopathy:ISHEN practice guidelines[J].Liver Int,2009,29(6):789-796.

施引文献

资源附件(0)

访问统计