[1]陈 杨,刘家成,杨崇图,等.经颈静脉肝内门体分流术后肝性脑病预后因素研究进展[J].介入放射学杂志,2022,31(03):301-306.
　CHEN Yang,LIU Jiacheng,YANG Chongtu,et al.Research progress in studying the prognostic factors of hepatic encephalopathy occurring after transjugular intrahepatic portosystemic shunt[J].journal interventional radiology,2022,31(03):301-306.
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经颈静脉肝内门体分流术后肝性脑病预后因素研究进展()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
31
期数:
2022年03
页码:
301-306
栏目:
综述
出版日期:
2022-03-25

文章信息/Info

Title:
Research progress in studying the prognostic factors of hepatic encephalopathy occurring after transjugular intrahepatic portosystemic shunt
作者:
陈 杨;  刘家成;  杨崇图;  石 钦;  王迎亮;  黄松江;  李铜强;  熊 斌
Author(s):
CHEN Yang;  LIU Jiacheng;  YANG Chongtu;  SHI Qin;  WANG Yingliang;  HUANG Songjiang;  LI Tongqiang;  XIONG Bin.
Department of Radiology， Affiliated Union Hospital， Tongji Medical College， Huazhong University of Science and Technology； Key Laboratory of Molecular Image of Hubei Province， Wuhan， Hubei Province 430022， China
关键词:
【关键词】 经颈静脉肝内门体分流术;  肝性脑病;  预后因素
文献标志码:
A
摘要:
 【摘要】1988年经颈静脉肝内门体分流术（TIPS）首次临床应用以来，TIPS相关理论和技术日益完善。然而术后肝性脑病（HE）发生仍是限制其临床广泛应用的主要并发症。因此，掌握TIPS术后HE发生的预后因素，可有效预防其发生。既往已有许多TIPS术后HE预后因素的报道，包括患者年龄、术前HE发生史、Child-Pugh分级、血氨水平、门静脉压力梯度等。本文主要就TIPS术后HE预后因素最新研究进展及本中心经验作一综述。

参考文献/References:

［1］ Garcia- Tsao G， Abraldes JG， Berzigotti A， et al. Portal hypertensive bleeding in cirrhosis： risk stratification， diagnosis， and management： 2016 practice guidance by the American Association for the Study of Liver Diseases［J］. Hepatology， 2017， 65： 310- 335.
［2］ Nolte W， Wiltfang J， Schindler C， et al. Portosystemic hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in patients with cirrhosis： clinical， laboratory， psychometric， and electroencephalographic investigations［J］. Hepatology， 1998， 28： 1215- 1225.
［3］ American Association for the Study of Liver Diseases， European Association for the Study of the Liver. Hepatic encephalopathy in chronic liver disease： 2014 practice guideline by the European Association for the Study of the Liver and the American Association for the Study of Liver Diseases［J］. J Hepatol， 2014，61：642- 659.
［4］ Ferenci P， Lockwood A， Mullen K， et al. Hepatic encephalopathy- definition， nomenclature， diagnosis， and quantification： final report of the working party at the 11th World Congresses of Gastroenterology， Vienna， 1998［J］. Hepatology， 2002， 35：716- 721.
［5］ Bai M， He CY， Qi XS， et al. Shunting branch of portal vein and stent position predict survival after transjugular intrahepatic portosystemic shunt［J］. World J Gastroenterol， 2014， 20： 774- 785.
［6］ Luo SH， Chu JG， Huang H， et al. Targeted puncture of left branch of intrahepatic portal vein in transjugular intrahepatic portosystemic shunt to reduce hepatic encephalopathy［J］. World J Gastroenterol， 2019， 25： 1088- 1099.
［7］ Rowley MW， Choi M， Chen S， et al. Refractory hepatic encephalopathy after elective transjugular intrahepatic portosystemic shunt： risk factors and outcomes with revision［J］. Cardiovasc Intervent Radiol， 2018， 41： 1765- 1772.
［8］ Roessle M， Gerbes AL. TIPS for the treatment of refractory ascites， hepatorenal syndrome and hepatic hydrothorax： a critical update［J］. Gut， 2010， 59： 988- 1000.
［9］ Schepis F， Vizzutti F， Garcia- Tsao G， et al. Under- dilated TIPS associate with efficacy and reduced encephalopathy in a prospective， non- randomized study of patients with cirrhosis［J］. Clin Gastroenterol Hepatol， 2018， 16： 1153.e7- 1162.e7.
［10］ Cui J， Smolinski SE， Liu F， et al. Incrementally expandable transjugular intrahepatic portosystemic shunts： single- center experience［J］. AJR Am J Roentgenol， 2018， 210： 438- 446.
［11］ Liu J， Ma J， Zhou C， et al. Potential benefits of underdilation of 8- mm covered stent in transjugular intrahepatic portosystemic shunt creation［J］. Clin Transl Gastroenterol， 2021， 12： e00376.
［12］ Wan YM， Li YH， Xu ZY， et al. Transjugular intrahepatic portosystemic shunt： the impact of portal venous pressure declines on shunt patency and clinical efficacy［J］. Acad Radiol， 2019， 26： 188- 195.
［13］ Riggio O， Angeloni S， Salvatori FM， et al. Incidence， natural history， and risk factors of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt with polytetrafluoroethylene- covered stent grafts［J］. Am J Gastroenterol， 2008， 103： 2738- 2746.
［14］ Dam G， Keiding S， Munk OL， et al. Hepatic encephalopathy is associated with decreased cerebral oxygen metabolism and blood flow， not increased ammonia uptake［J］. Hepatology， 2013， 57： 258- 265.
［15］ Chen HJ， Zheng G， Wichmann JL， et al. The brain following transjugular intrahepatic portosystemic shunt： the perspective from neuroimaging［J］. Metab Brain Dis， 2015， 30： 1331- 1341.
［16］ Zheng G， Zhang LJ， Wang Z， et al. Changes in cerebral blood flow after transjugular intrahepatic portosystemic shunt can help predict the development of hepatic encephalopathy： an arterial spin labeling MR study［J］. Eur J Radiol， 2012， 81： 3851- 3856.
［17］ Borentain P， Soussan J， Resseguier N， et al. The presence of spontaneous portosystemic shunts increases the risk of complications after transjugular intrahepatic portosystemic shunt （TIPS） placement［J］. Diagn Interv Imaging， 2016， 97： 643- 650.
［18］ Philips CA， Rajesh S， Augustine P， et al. Portosystemic shunts and refractory hepatic encephalopathy： patient selection and current options［J］. Hepat Med， 2019， 11： 23- 34.
［19］ Liu J， Yang C， Huang S， et al. The combination of balloon- assisted antegrade transvenous obliteration and transjugular intrahepatic portosystemic shunt for the management of cardiofundal varices hemorrhage［J］. Eur J Gastroenterol Hepatol， 2020， 32： 656- 662.
［20］ Lockwood AH. Blood ammonia levels and hepatic encephalopathy［J］. Metab Brain Dis， 2004， 19： 345- 349.
［21］ Bunchorntavakul C， Reddy KR. Review article： malnutrition/sarcopenia and frailty in patients with cirrhosis［J］. Aliment Pharmacol Ther， 2020， 51： 64- 77.
［22］ 原姗姗，韩国宏，樊代明． TIPS治疗门静脉高压并发症预后评价的现状［J］． 介入放射学杂志， 2011， 20：245- 248．
［23］ Merola J， Chaudhary N， Qian M， et al. Hyponatremia： a risk factor for early overt encephalopathy after transjugular intrahepatic portosystemic shunt creation［J］. J Clin Med， 2014， 3： 359- 372.
［24］ Iwasa M， Takei Y. Pathophysiology and management of hepatic encephalopathy 2014 update： ammonia toxicity and hyponatremia［J］. Hepatol Res， 2015， 45： 1155- 1162.
［25］ Xu X， Lin S， Yang Y， et al. Development of hyponatremia after terlipressin in cirrhotic patients with acute gastrointestinal bleeding： a retrospective multicenter observational study［J］. Expert Opin Drug Saf， 2020， 19： 641- 647.
［26］ Serra MA， Puchades MJ， Rodriguez F， et al. Clinical value of increased serum creatinine concentration as predictor of short- term outcome in decompensated cirrhosis［J］. Scand J Gastroenterol， 2004， 39： 1149- 1153.
［27］ Kalaitzakis E， Bjornsson E. Renal function and cognitive impairment in patients with liver cirrhosis［J］. Scand J Gastroenterol， 2007， 42： 1238- 1244.
［28］ Chen Q， Zhang Y， Yue ZD， et al. High- mobility group protein B1： a predictive biomarker for hepatic encephalopathy after transjugular intrahepatic portosystemic shunt［J］. J Hepatobiliary Pancreat Sci， 2020， 27： 522- 530.
［29］ Gao HM， Zhou H， Zhang F， et al. HMGB1 acts on microglia Mac1 to mediate chronic neuroinflammation that drives progressive neurodegeneration［J］. J Neurosci， 2011， 31： 1081- 1092.
［30］ Riggio O， Amodio P， Farcomeni A， et al. A model for predicting development of overt hepatic encephalopathy in patients with cirrhosis［J］. Clin Gastroenterol Hepatol， 2015， 13： 1346–1352.
［31］ Nardelli S， Gioia S， Pasquale C， et al. Cognitive impairment predicts the occurrence of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt［J］. Am J Gastroenterol， 2016， 111： 523- 528.
［32］ Biecker E， Hausdorfer I， Grunhage F， et al. Critical flicker frequency as a marker of hepatic encephalopathy in patients before and after transjugular intrahepatic portosystemic shunt［J］. Digestion， 2011， 83： 24- 31.
［33］ Nardelli S， Lattanzi B， Torrisi S， et al. Sarcopenia is risk factor for development of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt placement［J］. Clin Gastroenterol Hepatol， 2017， 15： 934- 936.
［34］ Luo L， Fu SY， Zhang YZ， et al. Early diet intervention to reduce the incidence of hepatic encephalopathy in cirrhosis patients： post- transjugular intrahepatic portosystemic shunt （TIPS） findings［J］. Asia Pac J Clin Nutr， 2016， 25： 497- 503.
［35］ 万岐江，侯蔚蔚，程维莉，等． TIPS术后患者延续护理干预研究［J］． 介入放射学杂志， 2016， 25：1104- 1108．
［36］ Yin X， Zhang F， Xiao J， et al. Diabetes mellitus increases the risk of hepatic encephalopathy after a transjugular intrahepatic portosystemic shunt in cirrhotic patients［J］. Eur J Gastroenterol Hepatol， 2019， 31： 1264- 1269.
［37］ Yin X， Zhang F， Guo H， et al. A nomogram to predict the risk of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in cirrhotic patients［J］. Sci Rep， 2020， 10： 9381.
［38］ Romero- Gomez M. Role of phosphate- activated glutaminase in the pathogenesis of hepatic encephalopathy［J］. Metab Brain Dis， 2005， 20： 319- 325.
［39］ Iebba V， Guerrieri F， Di Gregorio V， et al. Combining amplicon sequencing and metabolomics in cirrhotic patients highlights distinctive microbiota features involved in bacterial translocation， systemic inflammation and hepatic encephalopathy［J］. Sci Rep， 2018， 8： 8210.
［40］ Mehta G， Mookerjee RP， Sharma V， et al. Systemic inflammation is associated with increased intrahepatic resistance and mortality in alcohol- related acute- on- chronic liver failure［J］. Liver Int， 2015， 35： 724- 734.
［41］ Lewis DS， Lee TH， Konanur M， et al. Proton pump inhibitor use is associated with an increased frequency of new or worsening hepatic encephalopathy after transjugular intrahepatic portosystemic shunt creation［J］. J Vasc Interv Radiol， 2019， 30： 163- 169.
［42］ Sturm L， Bettinger D， Giesler M， et al. Treatment with proton pump inhibitors increases the risk for development of hepatic encephalopathy after implantation of transjugular intrahepatic portosystemic shunt（TIPS）［J］. United European Gastroenterol J， 2018， 6： 1380- 1390.
［43］ Dam G， Vilstrup H， Andersen PK， et al. Effect of proton pump inhibitors on the risk and prognosis of infections in patients with cirrhosis and ascites［J］. Liver Int， 2019， 39： 514- 521.
［44］ Dam G， Vilstrup H， Watson H， et al. Proton pump inhibitors as a risk factor for hepatic encephalopathy and spontaneous bacterial peritonitis in patients with cirrhosis with ascites［J］. Hepatology， 2016， 64： 1265- 1272.
［45］ Bureau C， Thabut D， Jezequel C， et al. The use of rifaximin in the prevention of overt hepatic encephalopathy after transjugular intrahepatic portosystemic shunt： a randomized controlled trial［J］. Ann Intern Med， 2021， 174： 633- 640.
［46］ Bass NM， Mullen KD， Sanyal A， et al. Rifaximin treatment in hepatic encephalopathy［J］. N Engl J Med， 2010， 362： 1071- 1081.
［47］ Liu J， Zhou C， Wang Y， et al. The combination of Child- Pugh score and quantitative CT- based spleen volume could predict the risk of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt creation［J］. Abdom Radiol（NY）， 2021， 46： 3464- 3470.
［48］ Malinchoc M， Kamath PS， Gordon FD， et al. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts［J］. Hepatology， 2000， 31： 864-871.
［49］ Biggins SW， Kim WR， Terrault NA， et al. Evidence- based incorporation of serum sodium concentration into MELD［J］. Gastroenterology， 2006， 130： 1652- 1660.
［50］ Wang P， Qi X， Xu K . Evolution， progress， and prospects of research on transjugular intrahepatic portosystemic shunt applications［J］. J Intervent Med， 2021， 4： 57- 61.
［51］ Rossle M， Richter GM， Noldge G， et al. New non- operative treatment for variceal haemorrhage［J］. Lancet， 1989， 2： 153.
［52］ Rosch J， Hanafee W， Snow H， et al. Transjugular intrahepatic portacaval shunt：an experimental work［J］. Am J Surg， 1971， 121：588- 592.

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备注/Memo

备注/Memo:
（收稿日期：2021- 03- 11）
（本文编辑：边 佶）
更新日期/Last Update: 2022-03-17