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논문 기본 정보

저자정보
(Kangwon National University School of Medicine)
저널정보
한국간담췌외과학회 한국간담췌외과학회 학술대회지 한국간담췌외과학회 2014년 제40차 춘계학술대회
발행연도
수록면
299 - 308 (10page)
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Hepatic Encephalopathy : Pathophysiology and Diagnosis
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    초록·키워드

    Hepatic encephalopathy (HE, also knownas portosystemic encephalopathy) is a serious neuropsychiatric complication as a result of liver dysfunction. This disease encompasses a broad range of symptoms characterized by personality changes, intellectual impairment, and a depressed level of consciousness with varying severity. Patients with HE have high mortality and poor quality of life, however, burden of this disease is increasing. Therefore, this review focused on the pathogenesis and diagnosis of HE. Although the precise molecular mechanisms are unclear, HE is the synergistic effects of excess ammonia and inflammation cause astrocyte swelling and cerebral edema. It is theorized that neurotoxic substances, including ammonia and manganese, may gain entry into the brain in the setting of liver failure. Also, it is known that neurosteroids, altered neurotransmission and oxidative stress involved in the pathogenesis of HE. The diagnosis of HE performed by a number of investigations, including clinical scales, neuropsychometric tests, neurophysiologic tests and brain imaging. Clinically, HE is best diagnosed by excluding other acute and chronic causes of altered mental status and confirming the diagnosis by a positive response to empiric treatment.

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