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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 10
Oct.  2011
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Advances in the diagnosis and treatment of hepatic encephalopathy

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  • Received Date: 2011-09-12
  • Published Date: 2011-10-20
  • Hepatic encephalopathy (HE) is a serious neuropsychiatric complication of both acute and chronic liver disease.Symptoms of HE can include confusion, disorientation and poor coordination.A general consensus exists that the synergistic effects of excess ammonia and inflammation cause astrocyte swelling and cerebral edema;however, the precise molecular mechanisms that lead to these morphological changes in the brain are unclear.The best treatment to HE is to remove causes and to clarify the diagnosis through empiric therapy.Empiric therapy for HE is largely based on the principle of reducing the production and absorption of ammonia in the gut through administration of pharmacological agents such as rifaximin and lactulose.

     

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    [3]Shawcross DL, Davies NA, Williams R, et al.Systemic in-flammatory response exacerbates the neuropsychologicaleffects of induced hyperammonemia in cirrhosis[J].J Hepa-tol, 2004, 40 (2) :247-254.
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    [5]Mardini H, Saxby BK, Record CO.Computerized psycho-metric testing in minimal encephalopathy and modulation bynitrogen challenge and liver transplant[J].Gastroenterolo-gy, 2008, 135 (5) :1582-1590.
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    [7]Muto Y, Sato S, Watanabe A, et al.Effects of oral branched-chain amino acid granules on event-free survival in pa-tients with liver cirrhosis[J].Clin Gastroenterol Hepatol, 2005, 3 (7) :705-713.
    [8]Bass NM, Mullen KD, Sanyal A, et al.Rifaximin treatmentin hepatic encephalopathy[J].N Engl J Med, 2010, 362 (12) :1071-1081.
    [9]Stewart CA, Malinchoc M, Kim WR, et al.Hepatic encepha-lopathy as a predictor of survival in patients with end-stageliver disease[J].Liver Transpl, 2007, 13 (10) :1366-1371.
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