Печеночная энцефалопатия: современное состояние проблемы и перспективы научных исследований

Аннотация

Hepatic encephalopathy is a common complication of liver dysfunction, including acute liver failure and liver cirrhosis. Hepatic encephalopathy presents as a spectrum of neuropsychiatric symptoms ranging from subtle fluctuating cognitive impairment to coma. It is a significant contributor of morbidity in patients with liver disease. Hepatic encephalopathy is observed in acute liver failure, liver bypass procedures, for example, shunt surgery and transjugular intrahepatic portosystemic shunt, and cirrhosis. These are classified as Type A, В and C hepatic encephalopathy, respectively. Hepatic encephalopathy can also be classified according to whether its presence is overt or covert. The pathogenesis is linked with ammonia and glutamine production, and treatment is based on mechanisms to reduce the formation and/or removal of these compounds. There is no specific diagnostic test for hepatic encephalopathy, and diagnosis is based on clinical suspicion, excluding other causes and use of clinical tests that may support its diagnosis. Many tests arc used in trials and experimentally, but have not yet gained universal acceptance. This review focuses on the definitions, pathogenesis and treatment of hepatic encephalopathy.