肠道微生态在隐匿性肝性脑病中发病机制及治疗前景  

The Pathogenesis and Treatment Prospect of Intestinal Microecology in Occult Hepatic Encephalopathy

作　　者：韦影影 何宛蓉[2] 梁运啸[2] 凌铭霞 WEI Yingying;HE Wanrong;LIANG Yunxiao;LING Mingxia(Graduate School of Youjiang Medical University for Nationalities,Baise 533000,Guangxi,China;Gastroenterology Department of Guangxi Zhuang Autonomous Region People′s Hospital,Nanning 530022,Guangxi,China;Guilin Medical University,Guilin 541000,Guangxi,China)

机构地区：[1]右江民族医学院研究生学院,广西百色533000 [2]广西壮族自治区人民医院消化内科,广西南宁530022 [3]桂林医学院,广西桂林541000

出　　处：《医学信息》2025年第4期188-192,共5页Journal of Medical Information

基　　金：广西卫健委科研课题(编号:Z20180684);广西自然科学基金项目(编号:2020JJB140211)。

摘　　要：隐匿性肝性脑病(CHE)是指通过神经心理学和(或)神经生理学发现异常,但患者可无症状或仅表现为轻度的认知障碍、失眠、睡眠倒错、计算力和注意力减弱等症状的一种肝性脑病,它不同于显性肝性脑病(OHE)出现的定向力障碍、扑翼样震颤等肝性脑病的典型症状,这种类型的肝性脑病不易被察觉。CHE易发展为OHE,降低了肝硬化患者的生存率,还影响患者精细操作能力,增加意外伤害风险,加重家庭和社会的负担。隐匿性肝性脑病发生的确切机制并未明确。近年来研究发现,肠道微生态的变化与肝性脑病的发生、发展及预后有密切的相关。本文旨在系统地对肠道微生态在隐匿性肝性脑病中的发生机制及治疗前景进行综述,深入探讨两者之间的关联,为临床防治CHE的手段提供理论依据。Covert hepatic encephalopathy(CHE)refers to a type of hepatic encephalopathy characterized by abnormalities discovered through neuropsychology and/or neurophysiology,but characterized by asymptomatic or only mild cognitive impairment,insomnia,sleep inversion,decreased computational and attention abilities.It is different from the typical symptoms of hepatic encephalopathy such as directional impairment and flapping tremors that appear in overt hepatic encephalopathy(OHE),and this type of hepatic encephalopathy is not easily detected.CHE is prone to develop into OHE,which reduces the survival rate of patients with liver cirrhosis,affects their fine motor skills,increases the risk of accidental injury,and increases the burden on families and society.The exact mechanism of covert hepatic encephalopathy is not yet clear.In recent years,research has found that changes in gut microbiota are closely related to the occurrence,development,and prognosis of hepatic encephalopathy.This article aims to systematically review the mechanism and treatment prospects of gut microbiota in Covert hepatic encephalopathy,and deeply explore the relationship between the two,providing theoretical basis for clinical prevention and treatment of CHE.

关 键 词：肝性脑病 隐匿性肝性脑病 肠道微生态 益生元 益生菌 

分 类 号：R575.3[医药卫生—消化系统]