肝性脑病是由于肝细胞功能衰竭所致的以神经、精神症状为主要表现的一系列临床症候群。随着对其发病机理、病理生理变化认识的加深,药物治疗有很大进展。 谷氨酸钠、谷氨酸钾、乙酰谷酰胺、精氨酸为常用降血氨药物,但经临床观察发现,谷氨酸钠、钾降血氨作用短暂,不易透过血脑屏障,且可造成减中毒。乙酰谷酰胺易通过血脑屏障进入脑组织,以谷氨酸形式与氨结合,似可降低脑脊液中氨的浓度,但最近研究发现其结合物谷氨酰胺为抑制性神经递质,可加重肝昏迷。精氨酸是肝脏通过鸟氨酸循环合成尿素的中间产物,其是否对鸟氨酸循环起 Hepatic encephalopathy is a series of clinical syndromes characterized by neurological and psychiatric symptoms due to failure of hepatocytes. With its pathogenesis, understanding of pathophysiological changes deepen, great progress has been made in drug treatment. Sodium glutamate, potassium glutamate, acetyl glutamine, arginine is commonly used antihypertensive drugs, but the clinical observation found that sodium glutamate, potassium hemopermanently transient, difficult to penetrate the blood-brain barrier, and Can result in reduced poisoning. Acetyl glutamine easily through the blood-brain barrier into the brain, in the form of glutamate with ammonia, may reduce the concentration of ammonia in cerebrospinal fluid, but recently found that the combination of glutamine as an inhibitory neurotransmitter, can aggravate the liver coma. Arginine is an intermediate product of the synthesis of urea by the liver through the ornithine cycle, whether it circulates ornithine