The therapeutic development of hepatic encephalopathy
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摘要: 肝性脑病(HE)是严重肝病常见的并发症和死亡原因。由于其发病机制不明确,目前仍以综合治疗为主。近年来在HE的治疗方面取得了很大进展,在传统治疗方法基础上,益生菌、锌制剂、抗幽门螺杆菌、血液净化、肝移植和胎儿肝干细胞移植等技术亦用于HE治疗。本文就HE治疗进展进行综述。Abstract: Hepatic encephalopathy (HE) is a common complication and common cause of death with severe liver diseases.As the pathogenesis of HE is unclear, current treatment is mainly focused on the comprehensive treatment.In recent years, there has been a great improvement in the treatment of HE.In addition to the conventional treatment, new therapy including probiotics, zinc preparation, blood purification, anti-helicobacter pylori, liver transplantation and fetal liver stem cell transplantation are used to treat HE.This article reviews the therapeutic development of HE.
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[1]Sharma P, Sharma BC, Sarin SK.Predictors of nonresponse to lactulose in patients with cirrhosis and hepatic encephalopathy[J].Eur J Gastroenterol Hepatol, 2010, 22 (5) :526-531. [2]Sharma P, Sharma BC, Sarin SK.Predictors of nonresponse to lactulose for minimal hepatic encephalopathy in patients with cirrhosis[J].Liver Int, 2009, 29 (9) :1365-1371. [3]Prasad S, Dhiman RK, Duseja A, et al.Lactulose imp-roves cognitive functions and health-related quality of life in patients with cirrhosis who have minimal hepatic encephalopathy[J].Hepatology, 2007, 45 (3) :549-559. [4]Bass NM, Mullen KD, Sanyal A, et al.Rifaximin treatment in hepatic encephalopathy[J].N Engl J Med, 2010, 362 (12) :1071-1081. [5]Basu P, Rayapudi K, Estevez J, et al.A pilot study utilizing nitazoxanide for hepatic encephalopathy in chronic liver failure[R].San Francisco, CA:Program and abstracts of the 59th Annual Meeting of the American Association for the Study of Liver Diseases, 2008, 1742. [6]Malaguarnera M, Gargante MP, Malaguarnera G, et al.Bifidobacterium combined with fructo-oligosaccharide versus lactulose in the treatment of patients with hepatic encephalo-pathy[J].Eur J Gastroenterol Hepatol, 2010, 22 (2) :199-206. [7]Schmid M, Peck-Radosavljevic M, Konig F, et al.A double-blind, randomized, placebo-controlled trial of intravenous L-ornithine-L-aspartate on postural control in patients with cirrhosis[J].Liver Int, 2010, 30 (4) :574-582. [8]Soárez PC, Oliveira AC, Padovan J.A critical analysis of studies assessing L-ornithine-L-aspartate (LOLA) in hepatic encephalopathy treatment[J].Arq Gastroenterol, 2009, 46 (3) :241-247. [9]Jalan R, Wright G, Davies NA, et al.L-Ornithine phenylacet-ate (OP) :a novel treatment for hyperammonemia and hepatic encephalopathy[J].Med Hypotheses, 2007, 69 (5) :1064-1069. [10]Al Sibae MR, McGuire BM.Current trends in the treatment of hepatic encephalopathy[J].Therapeutics and Clinical Risk Manag-ement, 2009, 5 (3) :617-626. [11]Malaguarnera M, Gargante MP, Cristaldi E, et al.Acetyl-L-carnitine treatment in minimal hepatic encephalopathy[J].Dig Dis Sci, 2008, 53 (11) :3018-3025. [12]Abdel-Hady H, Zaki A, Badra G, et al.Helicobacter pyl-ori infection in hepatic encephalopathy:Relationship to plasma endotoxins and blood ammonia[J].Hepatol Res, 2007, 37 (12) :1026-1033. [13]Als-Nielsen B, Gluud LL, Gluud C.Benzodiazepine receptor antagonists for hepatic encephalopathy[J].Cochrane Database Syst Rev, 2004, 34 (2) :2798-2803. [14]Hamed SA, Hamed EA, Farghaly MH, et al.Trace elements and flapping tremors in patients with liver cirrhosis.Is there a relationship[J].Saudi Med J, 2008, 29 (3) :345-351. [15]Katayama K.Ammonia metabolism and hepatic ence-phalo-pathy[J].Hepatol Res, 2004, 30 (2) :73-79. [16]秦万龙, 张静, 李伦, 等.纳洛酮对肝性脑病疗效的系统评价[J].兰州大学学报, 2009, 35 (3) :55-63. [17]欧阳伟.人工肝血浆置换治疗肝性脑病的临床观察[J].临床军医杂志, 2007, 35 (6) :852-854. [18]周生明, 刘伟.人工肝血液灌流治疗重型肝炎合并肝性脑病疗效观察[J].中国血液净化, 2005, 4 (6) :339-340. [19]王海艳, 李红伟, 毛敬珍.连续性血液滤过治疗重型肝炎合并肝性脑病16例临床疗效观察[J].临床肝胆病杂志, 2009, 25 (5) :364-365. [20]Wang MM, Chen SJ, Ye QF, et al.Liver support therapy with molecular adsorbents recirculating system in liver failure:a summary of 252 cases from 14 centers in China[J].Chin Med J (Engl) , 2008, 121 (21) :2197-2201. [21]Koivusalo AM, Kantola T, Arola J, et al.Is it possible to gain extra waiting time to liver transplantation in acute liver failure patients using albumin dialysis[J].Ther Apher Dial, 2009, 13 (5) :413-418. [22]Khan AA, Shaik MV, Parveen N, et al.Human fetal liver derived stem cell transplantation as supportive modality in the management of end stage decompensated liver cirrhosis[J].Cell Transplant, 2010, 19 (4) :409-418. [23]Tang XN, Yenari MA.Hypothermia as a cytoprotective strategy in ischemic tissue injury[J].Ageing Res Rev, 2010, 9 (1) :61-68.
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