白蛋白治疗在肝性脑病中的研究进展  

Research progress on albumin therapy for hepatic encephalopathy

作　　者：周志玲 张大志[1] Zhou Zhiling;Zhang Dazhi(Department of Infectious Diseases,Key Laboratory of Molecular Biology for Infectious Diseases(Ministry of Education),Institute for Viral Hepatitis,the Second Affiliated Hospital,Chongqing Medical University,Chongqing 401336,China)

机构地区：[1]重庆医科大学附属第二医院感染科,重庆医科大学感染性疾病分子生物学教育部重点实验室,重庆医科大学病毒性肝炎研究所,重庆401336

出　　处：《中华肝脏病杂志》2024年第9期861-864,共4页Chinese Journal of Hepatology

基　　金：重庆医科大学附属第二医院卓越创新临床研究项目;重庆市公共卫生重点专科(学科)建设经费资助。

摘　　要：肝性脑病是由肝功能不全和/或门体分流引起的脑功能障碍,是肝硬化失代偿期的严重并发症之一,通常表现为从亚临床改变到昏迷的广泛的神经或精神异常。肝性脑病的发病机制复杂,主要与氨中毒有关,氧化应激、炎症和肠道菌群失调等也在其中发挥了重要作用。肝性脑病的治疗缺乏特效药物,目前可使用的药物包括不可吸收的二糖(如乳果糖)、抗生素(如利福昔明)、其他疗法(如口服支链氨基酸、静脉注射L-鸟氨酸-L-天冬氨酸、益生菌)等。近年研究表明人血白蛋白治疗HE安全有效,不仅能改善患者脑功能,而且能提高患者的生活质量。Hepatic encephalopathy(HE)is one of the severe complications of decompensated stage cirrhosis that causes cerebral dysfunction due to hepatic insufficiency and/or portosystemic shunts,and it usually manifests as a wide spectrum of neurological or psychiatric abnormalities ranging from subclinical alterations to coma.The pathogenesis of HE is complex,although ammonia toxicity,oxidative stress,inflammation,intestinal dysbiosis,and others among them mainly play an important role.The treatment for HE lacks specific drugs,and the current available drugs include non-absorbable disaccharides(lactulose),antibiotics(rifaximin),and other therapies(oral branched-chain amino acids,intravenous injection of L-ornithine-L-aspartic acid,probiotics).Recent research has shown that human albumin is a safe and effective treatment for HE,improving not only cognitive function but also enhancing patients'quality of life.

关 键 词：白蛋白 肝性脑病 肝硬化 认知功能 治疗 

分 类 号：R575.3[医药卫生—消化系统]