肝硬化轻微型肝性脑病纳入与排除标准制定之我见
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摘要
<正>肝性脑病(Hepatic Encephalopathy,HE)是肝硬化患者常见的并发症之一,根据其认知损害程度可分为轻微型肝性脑病(Minimal Hepatic Encephalopathy,MHE)和显性肝性脑病(Overt Hepatic Encephalopathy,OHE)。MHE是肝性脑病的早期阶段,临床表现隐匿,仅神经心理学或神经生理学检测异常,OHE是MHE由不断进展导致,出现行为异常和意识障碍等中枢神经系统病理表现。随着近年来国内外MHE研究逐
引文
[1]Vilstrup H,Amodio P,Bajaj JS,et al.Hepatic encephalopathy in chronic liver disease:2014 Practice Guideline by the American Association for the study of liver diseases and the european association for the study of the liver.Hepatology,2014,60:715-735.
[2]中华医学会消化病学分会,中华医学会肝病学分会.中国肝性脑病诊治共识意见(2013年,重庆).中华肝脏病杂志,2013,21:641-643.
[3]中华医学会肝病学分会.肝硬化肝性脑病诊疗指南.中华内科杂志.2018,57:705-718.
[4]Shan C, Lee SY, Chang YH,et al. Neuropsychological functions in Han Chinese patients in Taiwan with bipolar II disorder comorbid and not comorbid with alcohol abuse/alcohol dependence disorder. Prog Neuropsychopharmacol Biol Psychiatry,2011,35:131-136.
[5]Guerri C,Pascual M.Mechanisms involved in the neurotoxic,cognitive,and neurobehavioral effects of alcohol consumption during adolescence.Alcohol,2010,44:15-26.
[6]李杰,张大均.酒精认知功能减退研究述评.重庆第二师范学院学报,2012,25:12-15.
[7]Fitzpatrick LE,Crowe SF.Cognitive and emotional deficits inchronic alcoholics:a role for the cerebellum?Cerebellum,2013,12:520-533.
[8]Campbell JA,Samartgisa JR,Crowe SF.Impaired decision makingon the balloon analogue risk task as a result of long-term alcoholuse.J Clin Exp Neuropsychol,2013,35:1071-1081.
[9]Amodio P, Pellegrini AAmistàP, Luise S, et al.Neuropsychological-neurophysiological alterations and brain atrophy in cirrhotic patients.Metab Brain Dis,2003,18:63-78.
[10]Myers R,Shaheen A,Li B,et al.Impact of liver disease,alcohol abuse,and unintentional ingestions on the outcomes of acetaminophen overdose.Clin Gastroenterol Hepatol,2008,6:918-925;quiz 837.
[11]Campagna F,Montagnese S,Schiff S,et al.Confounders in the detection of minimal hepatic encephalopathy:a neuropsychological and quantified EEG study.Liver Int,2015,35:1524-1532.
[12]Montagnese S, Biancardi A, Schiff S, et al. Different biochemical correlates for different neuropsychiatric abnormalities in patients with cirrhosis.Hepatology,2011,53:558-566.
[13]Zuo Z,Fan H,Tang XD,et al.Effect of different treatments and alcohol addiction on gut microbiota in minimal hepatic encephalopathy patients.Exp Ther Med,2017,14:4887-4895.
[14]Romerogómez M, Boza F, Garcíavaldecasas MS, et al.Subclinical hepatic encephalopathy predicts the development of overt hepatic encephalopathy.Am J Gastroenterol,2001,96:2718-2723.
[15]Goldbecker A,Weissenborn K,Hamidi Shahrezaei G,et al.Comparison of the most favoured methods for the diagnosis of hepatic encephalopathy in liver transplantation candidates.Gut,2013,62:1497-1504.
[16]Wang JY,Zhang NP,Chi BR,et al.Prevalence of minimal hepatic encephalopathy and quality of life evaluations in hospitalized cirrhotic patients in China.World J Gastroenterol,2013,19:4984-4991.
[2]中华医学会消化病学分会,中华医学会肝病学分会.中国肝性脑病诊治共识意见(2013年,重庆).中华肝脏病杂志,2013,21:641-643.
[3]中华医学会肝病学分会.肝硬化肝性脑病诊疗指南.中华内科杂志.2018,57:705-718.
[4]Shan C, Lee SY, Chang YH,et al. Neuropsychological functions in Han Chinese patients in Taiwan with bipolar II disorder comorbid and not comorbid with alcohol abuse/alcohol dependence disorder. Prog Neuropsychopharmacol Biol Psychiatry,2011,35:131-136.
[5]Guerri C,Pascual M.Mechanisms involved in the neurotoxic,cognitive,and neurobehavioral effects of alcohol consumption during adolescence.Alcohol,2010,44:15-26.
[6]李杰,张大均.酒精认知功能减退研究述评.重庆第二师范学院学报,2012,25:12-15.
[7]Fitzpatrick LE,Crowe SF.Cognitive and emotional deficits inchronic alcoholics:a role for the cerebellum?Cerebellum,2013,12:520-533.
[8]Campbell JA,Samartgisa JR,Crowe SF.Impaired decision makingon the balloon analogue risk task as a result of long-term alcoholuse.J Clin Exp Neuropsychol,2013,35:1071-1081.
[9]Amodio P, Pellegrini AAmistàP, Luise S, et al.Neuropsychological-neurophysiological alterations and brain atrophy in cirrhotic patients.Metab Brain Dis,2003,18:63-78.
[10]Myers R,Shaheen A,Li B,et al.Impact of liver disease,alcohol abuse,and unintentional ingestions on the outcomes of acetaminophen overdose.Clin Gastroenterol Hepatol,2008,6:918-925;quiz 837.
[11]Campagna F,Montagnese S,Schiff S,et al.Confounders in the detection of minimal hepatic encephalopathy:a neuropsychological and quantified EEG study.Liver Int,2015,35:1524-1532.
[12]Montagnese S, Biancardi A, Schiff S, et al. Different biochemical correlates for different neuropsychiatric abnormalities in patients with cirrhosis.Hepatology,2011,53:558-566.
[13]Zuo Z,Fan H,Tang XD,et al.Effect of different treatments and alcohol addiction on gut microbiota in minimal hepatic encephalopathy patients.Exp Ther Med,2017,14:4887-4895.
[14]Romerogómez M, Boza F, Garcíavaldecasas MS, et al.Subclinical hepatic encephalopathy predicts the development of overt hepatic encephalopathy.Am J Gastroenterol,2001,96:2718-2723.
[15]Goldbecker A,Weissenborn K,Hamidi Shahrezaei G,et al.Comparison of the most favoured methods for the diagnosis of hepatic encephalopathy in liver transplantation candidates.Gut,2013,62:1497-1504.
[16]Wang JY,Zhang NP,Chi BR,et al.Prevalence of minimal hepatic encephalopathy and quality of life evaluations in hospitalized cirrhotic patients in China.World J Gastroenterol,2013,19:4984-4991.