<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">nogr</journal-id><journal-title-group><journal-title xml:lang="ru">Экспериментальная и клиническая гастроэнтерология</journal-title><trans-title-group xml:lang="en"><trans-title>Experimental and Clinical Gastroenterology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1682-8658</issn><publisher><publisher-name>«Global Media Technologies»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.31146/1682-8658-ecg-191-7-90-98</article-id><article-id custom-type="elpub" pub-id-type="custom">nogr-1705</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОР</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEW</subject></subj-group></article-categories><title-group><article-title>Печеночная энцефалопатия: современные аспекты диагностики и лечения</article-title><trans-title-group xml:lang="en"><trans-title>Hepatic encephalopathy: modern aspects of diagnosis and treatment</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Подымова</surname><given-names>С. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Podymova</surname><given-names>S. D.</given-names></name></name-alternatives><email xlink:type="simple">spodymova@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Винницкая</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Vinnitskaya</surname><given-names>E. V.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2313-9748</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хайменова</surname><given-names>Т. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Khaimenova</surname><given-names>T. Yu.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ГБУЗ Московский Клинический Научный Центр им. А. С. Логинова ДЗМ</institution><country>Россия</country></aff><aff xml:lang="en"><institution>The Loginov Moscow Clinical Scientific Center is State Institution funded by Moscow Health Department</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2021</year></pub-date><pub-date pub-type="epub"><day>27</day><month>09</month><year>2021</year></pub-date><volume>0</volume><issue>7</issue><fpage>90</fpage><lpage>98</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Подымова С.Д., Винницкая Е.В., Хайменова Т.Ю., 2021</copyright-statement><copyright-year>2021</copyright-year><copyright-holder xml:lang="ru">Подымова С.Д., Винницкая Е.В., Хайменова Т.Ю.</copyright-holder><copyright-holder xml:lang="en">Podymova S.D., Vinnitskaya E.V., Khaimenova T.Y.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.nogr.org/jour/article/view/1705">https://www.nogr.org/jour/article/view/1705</self-uri><abstract><p>Новым подходом к диагностике ПЭ явилось выделение в последние годы скрытой и явной ПЭ. Подробная оценка стадий ПЭ, представленная в работе, фактически отражает степень тяжести заболевания. Диагноз скрытой ПЭ устанавливается по результатам проведения минимум двух психометрических тестов, повторенных в динамике, и данным одного компьютеризированного теста. Диагноз явной ПЭ часто ставится методом «исключения» других возможных причин нарушения функции мозга. Показано, что эффективная терапия ПЭ основывается не только на особенностях патогенеза, но невозможна без учета различных вариантов течения ПЭ, степени тяжести заболевания. На основании рандомизированных контролированных исследований, выполненных в последние годы, разработана эффективная стратегия лечения различных форм ПЭ: эпизодической, рецидивирующей. Рецидивирующая, резистентная к терапии, явная ПЭ на фоне печеночной недостаточности является показанием к трансплантации печени.</p></abstract><trans-abstract xml:lang="en"><p>A new approach to the diagnosis of PE has been the identification of latent and overt PE in recent years. The detailed assessment of the stages of PE presented in the paper actually reflects the severity of the disease. The diagnosis of latent PE is established based on the results of at least two psychometric tests repeated in dynamics, and the data of one computerized test. The diagnosis of apparent PE is often made by “excluding” other possible causes of brain dysfunction. It is shown that effective therapy of PE is based not only on the features of the pathogenesis, but is impossible without taking into account the various variants of the course of PE, the severity of the disease. Based on randomized controlled trials conducted in recent years, an effective strategy for the treatment of various forms of PE has been developed: episodic, recurrent. Recurrent, therapy-resistant, and obvious PE in the presence of hepatic insufficiency is an indication for liver transplantation.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>печеночная энцефалопатия</kwd><kwd>патогенез</kwd><kwd>клинические особенности</kwd><kwd>диагностика</kwd><kwd>градация стадий ПЭ</kwd><kwd>дифференциальный диагноз ПЭ</kwd><kwd>лечение</kwd><kwd>трансплантация печени</kwd></kwd-group><kwd-group xml:lang="en"><kwd>hepatic encephalopathy</kwd><kwd>pathogenesis</kwd><kwd>clinical features</kwd><kwd>diagnosis</kwd><kwd>gradation of the stages of PE</kwd><kwd>differential diagnosis of PE</kwd><kwd>treatment</kwd><kwd>liver transplantation</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">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. Hepatology. 2002; 35(3):716-721.DOI: 10.1053/ jhep.2002.31250.</mixed-citation><mixed-citation xml:lang="en">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. Hepatology. 2002; 35(3):716-721.DOI: 10.1053/ jhep.2002.31250.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Podymova S. D. Liver Diseases: Manual. The 5t hed., revisead and srepplemented. Moscow: Medical Informational Agency, 2018. 984 p. (in Russ.)@@ Подымова С. Д. «Болезни печени: руководство для врачей. - Изд. 5-е, перераб. и доп. - Москва: ООО «Медицинское информационное агенство». 2018-984 с.</mixed-citation><mixed-citation xml:lang="en">Podymova S. D. Liver Diseases: Manual. The 5t hed., revisead and srepplemented. Moscow: Medical Informational Agency, 2018. 984 p. (in Russ.)@@ Подымова С. Д. «Болезни печени: руководство для врачей. - Изд. 5-е, перераб. и доп. - Москва: ООО «Медицинское информационное агенство». 2018-984 с.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Cordoba J. New assessment of hepatic encephalopathy. J Hepatol. 2011; 54:1030-1040.</mixed-citation><mixed-citation xml:lang="en">Cordoba J. New assessment of hepatic encephalopathy. J Hepatol. 2011; 54:1030-1040.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Shawcross DL, Dunk AA, Jalan R, et al. How to diagnose and manage hepatic encephalopathy: a consensus statement on roles and responsibilities beyond the liver specialist. Eur J Gastrenterol Hepatol. 2016 Feb. 28(2):146-52, DOI: 10.1097/MEG.0000000000000529</mixed-citation><mixed-citation xml:lang="en">Shawcross DL, Dunk AA, Jalan R, et al. How to diagnose and manage hepatic encephalopathy: a consensus statement on roles and responsibilities beyond the liver specialist. Eur J Gastrenterol Hepatol. 2016 Feb. 28(2):146-52, DOI: 10.1097/MEG.0000000000000529</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">An-Jiang Wang, A-Ping Peng, Bi-Min Li, Na Gan, Li Pei, Xue-Lian Zheng, Jun-Bo Hong, Hai-Ying Xiao, Jia-Wei Zhong, Xuan Zhu. Natural history of covert hepatic encephalopathy: Anobservational study of 366 cirrhotic patients Observational Study. World J Gastroenterol 2017 September 14; 23(34): 6321-6329. DOI:10.3748/wjg.v23.i34.6321</mixed-citation><mixed-citation xml:lang="en">An-Jiang Wang, A-Ping Peng, Bi-Min Li, Na Gan, Li Pei, Xue-Lian Zheng, Jun-Bo Hong, Hai-Ying Xiao, Jia-Wei Zhong, Xuan Zhu. Natural history of covert hepatic encephalopathy: Anobservational study of 366 cirrhotic patients Observational Study. World J Gastroenterol 2017 September 14; 23(34): 6321-6329. DOI:10.3748/wjg.v23.i34.6321</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Brusilow SW. Hyperammonemic encephalopathy. Medicine (Baltimore). 2002 May. 81(3):240-9.</mixed-citation><mixed-citation xml:lang="en">Brusilow SW. Hyperammonemic encephalopathy. Medicine (Baltimore). 2002 May. 81(3):240-9.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Butterworth RF. Hepatic encephalopathy in Cirrhosis: Pathology and Pathophysiology. Drugs 2019; 79 (Suppl 1): S17-21. DOI: 10.1007/s40265-018-1017-011.</mixed-citation><mixed-citation xml:lang="en">Butterworth RF. Hepatic encephalopathy in Cirrhosis: Pathology and Pathophysiology. Drugs 2019; 79 (Suppl 1): S17-21. DOI: 10.1007/s40265-018-1017-011.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Butterworth RF. Hepatic encephalopathy: a central neuroinflammatory disorder? J. Hepatology. 2011; 53:1372-6. DOI:10.1002/hep.24228.</mixed-citation><mixed-citation xml:lang="en">Butterworth RF. Hepatic encephalopathy: a central neuroinflammatory disorder? J. Hepatology. 2011; 53:1372-6. DOI:10.1002/hep.24228.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Butterworth RF. Neuronal cell death in hepatic encephalopathy. Metab. Brain Dis. 2007; 22:309-20. DOI: 10.1007/s11011-007-9072-3.</mixed-citation><mixed-citation xml:lang="en">Butterworth RF. Neuronal cell death in hepatic encephalopathy. Metab. Brain Dis. 2007; 22:309-20. DOI: 10.1007/s11011-007-9072-3.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Felipo V, Butterworth RF. Neurobiology of ammonia. Prog Neurobiol. 2002; 67:259-79.</mixed-citation><mixed-citation xml:lang="en">Felipo V, Butterworth RF. Neurobiology of ammonia. Prog Neurobiol. 2002; 67:259-79.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Burkhard PR, Delavelle J, Du Pasquier R, Spahr L. Chronic рarkinsonism associated with cirrhosis. Arch Neurol.2003; 60(4):521-8.</mixed-citation><mixed-citation xml:lang="en">Burkhard PR, Delavelle J, Du Pasquier R, Spahr L. Chronic рarkinsonism associated with cirrhosis. Arch Neurol.2003; 60(4):521-8.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">E. V. Golovanova Ammonia is an actual problem of a doctor and a patient in therapeutic practice. Therapy. 2018, No. 2, pp. 49-55. (in Russ.)@@ Голованова Е. В. Аммиак-актуальная проблема врача и пациента в терапевтической практике. Терапия. 2018 № 2 С. 49-55.</mixed-citation><mixed-citation xml:lang="en">E. V. Golovanova Ammonia is an actual problem of a doctor and a patient in therapeutic practice. Therapy. 2018, No. 2, pp. 49-55. (in Russ.)@@ Голованова Е. В. Аммиак-актуальная проблема врача и пациента в терапевтической практике. Терапия. 2018 № 2 С. 49-55.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Рavlov C. S., Damulin I. V., Ivashkin V. T. Hepatic encephalopathy: pathogenesis, clinical presentation, diagnostics, treatment. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2016. 26(1):44-53. (In Russ.) Doi: 10.22416/1382-4376-2016-26-1-44-53@@ Павлов Ч. С., Дамулин И. В., Ивашкин В. Т. Печеночная энцефалопатия: патогенез, клиника, диагностика, терапия. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2016. 26(1):44-53.</mixed-citation><mixed-citation xml:lang="en">Рavlov C. S., Damulin I. V., Ivashkin V. T. Hepatic encephalopathy: pathogenesis, clinical presentation, diagnostics, treatment. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2016. 26(1):44-53. (In Russ.) Doi: 10.22416/1382-4376-2016-26-1-44-53@@ Павлов Ч. С., Дамулин И. В., Ивашкин В. Т. Печеночная энцефалопатия: патогенез, клиника, диагностика, терапия. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2016. 26(1):44-53.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Conn H. O., Liberthal M. M. The Hepatic Coma Syndromesa and Lactulose. Williams, Wilkins.Baltmore/ London.1978, 514p.</mixed-citation><mixed-citation xml:lang="en">Conn H. O., Liberthal M. M. The Hepatic Coma Syndromesa and Lactulose. Williams, Wilkins.Baltmore/ London.1978, 514p.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Hendrik Vilstrup, Piero Amodio, Jasmohan Bajaj, Juan Cordoba, Peter Ferenci, Kevin D Mullen, Karin Weissenborn, Philip Wong. Hepatic Encephalopathy in Chronic Liver Disease: 2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. Hepatology 2014 Aug; 60(2):715-35. DOI: 10.1002/hep.27210. Epub. 2014 Jul 8.</mixed-citation><mixed-citation xml:lang="en">Hendrik Vilstrup, Piero Amodio, Jasmohan Bajaj, Juan Cordoba, Peter Ferenci, Kevin D Mullen, Karin Weissenborn, Philip Wong. Hepatic Encephalopathy in Chronic Liver Disease: 2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. Hepatology 2014 Aug; 60(2):715-35. DOI: 10.1002/hep.27210. Epub. 2014 Jul 8.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Podymova S. D. New approaches to the pathogenesis, clinic, and treatment of hepatic encephalopathy. New approaches to the pathogenesis, clinic, and treatment of hepatic encephalopathy. Terapevticheskii Arkhiv (Ter. Arkh.). 2021; 93 (2): 236-242. (In Russ) DOI: 10.26442/00403660.2021.02.200613@@ Подымова С. Д. Новые подходы к патогенезу, клинике, лечению печеночной энцефалопатии. Терапевтический архив. 2021; 93 (2): 236-242. DOI: 10.26442/00403660.2021.02.200613.</mixed-citation><mixed-citation xml:lang="en">Podymova S. D. New approaches to the pathogenesis, clinic, and treatment of hepatic encephalopathy. New approaches to the pathogenesis, clinic, and treatment of hepatic encephalopathy. Terapevticheskii Arkhiv (Ter. Arkh.). 2021; 93 (2): 236-242. (In Russ) DOI: 10.26442/00403660.2021.02.200613@@ Подымова С. Д. Новые подходы к патогенезу, клинике, лечению печеночной энцефалопатии. Терапевтический архив. 2021; 93 (2): 236-242. DOI: 10.26442/00403660.2021.02.200613.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Wolf David C. Hepatic Encephalopathy. Access May 18, 2020. https://emedicine.medscape.com/article/186101-print</mixed-citation><mixed-citation xml:lang="en">Wolf David C. Hepatic Encephalopathy. Access May 18, 2020. https://emedicine.medscape.com/article/186101-print</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Caldwell C, Werdiger N, Jakab S, et al. Use of model for end-stage liver disease exception points for early liver transplantation and successful reversal of hepatic myelopathy with a review of the literature. Liver Transpl. 2010 Jul. 16(7):818-26. DOI: 10.1002/lt.22077.</mixed-citation><mixed-citation xml:lang="en">Caldwell C, Werdiger N, Jakab S, et al. Use of model for end-stage liver disease exception points for early liver transplantation and successful reversal of hepatic myelopathy with a review of the literature. Liver Transpl. 2010 Jul. 16(7):818-26. DOI: 10.1002/lt.22077.</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Bajaj JS, Gillevet PM, Patel NR, Ahluwalia V, Ridlon JM, Kettenmann B, et al. A longitudinal systems biology analysis of lactulose withdrawal in hepatic encephalopathy. Metab Brain Dis 2012; 27:205-215.</mixed-citation><mixed-citation xml:lang="en">Bajaj JS, Gillevet PM, Patel NR, Ahluwalia V, Ridlon JM, Kettenmann B, et al. A longitudinal systems biology analysis of lactulose withdrawal in hepatic encephalopathy. Metab Brain Dis 2012; 27:205-215.</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Lazebnik LB, Golovanova EV, Alekseenko SA, et al. Russian consensus “Hyperammonemia in adults” Experimental and clinical gastroenterology. 2019 issue 172 (12) pp. 4-23. DOI: 10.31146 / 1682-8658-ecg-172-12-4-23. (In Russ.)@@ Лазебник Л. Б., Голованова Е. В., Алексеенко С. А. и др. Российский консенсус «Гипераммониемии у взрослых» Экспериментальная и клиническая гастроэнтерология. 2019 выпуск 172 (12) с. 4-23. DOI: 10.31146/1682-8658-ecg-172-12-4-23.</mixed-citation><mixed-citation xml:lang="en">Lazebnik LB, Golovanova EV, Alekseenko SA, et al. Russian consensus “Hyperammonemia in adults” Experimental and clinical gastroenterology. 2019 issue 172 (12) pp. 4-23. DOI: 10.31146 / 1682-8658-ecg-172-12-4-23. (In Russ.)@@ Лазебник Л. Б., Голованова Е. В., Алексеенко С. А. и др. Российский консенсус «Гипераммониемии у взрослых» Экспериментальная и клиническая гастроэнтерология. 2019 выпуск 172 (12) с. 4-23. DOI: 10.31146/1682-8658-ecg-172-12-4-23.</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Stewart CA, Reivich M, Lucey MR, et al. Neuroimaging in hepatic encephalopathy. Clin Gastroenterol Hepatol. 2005 Mar. 3(3):197-207.</mixed-citation><mixed-citation xml:lang="en">Stewart CA, Reivich M, Lucey MR, et al. Neuroimaging in hepatic encephalopathy. Clin Gastroenterol Hepatol. 2005 Mar. 3(3):197-207.</mixed-citation></citation-alternatives></ref><ref id="cit22"><label>22</label><citation-alternatives><mixed-citation xml:lang="ru">Likhachev S., Suprun V., Korotkov S., Dzyadzko A. Hepatic encephalopathy: definition, classification, etiopathogenesis. Neurology and Neurosurgery. Eastern Europe, 2018, volume 8, no. 2, pp. 290-295 (in Russ.)@@ Лихачев С. А., Супрун В. Е., Коротков С. В., Дзядзько А. М. Печеночная энцефалопатия: классификация, диагностика, лечение. Неврология и нейрохирургия. Восточная Европа, 2018, том 8, № 2, 290-295.</mixed-citation><mixed-citation xml:lang="en">Likhachev S., Suprun V., Korotkov S., Dzyadzko A. Hepatic encephalopathy: definition, classification, etiopathogenesis. Neurology and Neurosurgery. Eastern Europe, 2018, volume 8, no. 2, pp. 290-295 (in Russ.)@@ Лихачев С. А., Супрун В. Е., Коротков С. В., Дзядзько А. М. Печеночная энцефалопатия: классификация, диагностика, лечение. Неврология и нейрохирургия. Восточная Европа, 2018, том 8, № 2, 290-295.</mixed-citation></citation-alternatives></ref><ref id="cit23"><label>23</label><citation-alternatives><mixed-citation xml:lang="ru">Podymova S. D. Hepatic encephalopathy associated with cirrhosis of the liver. Modern approaches to pathogenesis, clinic, and treatment. Experimental and clinical gastroenterology. 2017; (11): 4-12. (in Russ.)@@ Подымова С. Д. Печеночная энцефалопатия, связанная с циррозом печени. Современные подходы к патогенезу, клинике, лечению. Экспериментальная и клиническая гастроэнтерология. 2017(11): 4-12.</mixed-citation><mixed-citation xml:lang="en">Podymova S. D. Hepatic encephalopathy associated with cirrhosis of the liver. Modern approaches to pathogenesis, clinic, and treatment. Experimental and clinical gastroenterology. 2017; (11): 4-12. (in Russ.)@@ Подымова С. Д. Печеночная энцефалопатия, связанная с циррозом печени. Современные подходы к патогенезу, клинике, лечению. Экспериментальная и клиническая гастроэнтерология. 2017(11): 4-12.</mixed-citation></citation-alternatives></ref><ref id="cit24"><label>24</label><citation-alternatives><mixed-citation xml:lang="ru">EASL Clinical Practice Guidelines on nutrition in chronic liver disease. Journal of Hepatology. 2019 Jan., Vol. 70, P 172-193. DOI: 10.1016/j.hep.2018.06.024.</mixed-citation><mixed-citation xml:lang="en">EASL Clinical Practice Guidelines on nutrition in chronic liver disease. Journal of Hepatology. 2019 Jan., Vol. 70, P 172-193. DOI: 10.1016/j.hep.2018.06.024.</mixed-citation></citation-alternatives></ref><ref id="cit25"><label>25</label><citation-alternatives><mixed-citation xml:lang="ru">Sharma B. C., et al: Secondary prophylaxis of hepatic encephalopathy: an open-label randomized controlled trial of lactulose versus placebo. Gastroenterology 2009; v137:885-891 DOI: 10.1053 / j.gastro.2009.05.056. ID корпуса: 19779523.</mixed-citation><mixed-citation xml:lang="en">Sharma B. C., et al: Secondary prophylaxis of hepatic encephalopathy: an open-label randomized controlled trial of lactulose versus placebo. Gastroenterology 2009; v137:885-891 DOI: 10.1053 / j.gastro.2009.05.056. ID корпуса: 19779523.</mixed-citation></citation-alternatives></ref><ref id="cit26"><label>26</label><citation-alternatives><mixed-citation xml:lang="ru">Bajaj JS. Review article: potential mechanisms of action of rifaximin in the management of hepatic encephalopathy and other complications of cirrhosis. Aliment Pharmacol Ther. 2016 Jan. 43 suppl 1:11-26. DOI: 10.1111/apt.1343.</mixed-citation><mixed-citation xml:lang="en">Bajaj JS. Review article: potential mechanisms of action of rifaximin in the management of hepatic encephalopathy and other complications of cirrhosis. Aliment Pharmacol Ther. 2016 Jan. 43 suppl 1:11-26. DOI: 10.1111/apt.1343.</mixed-citation></citation-alternatives></ref><ref id="cit27"><label>27</label><citation-alternatives><mixed-citation xml:lang="ru">Bass NM, Mullen KD, Sanyal A, et al. Rifaximin treatment in hepatic encephalopathy. N Engl J Med. 2010 Mar 25. 362 (12):1071-81.</mixed-citation><mixed-citation xml:lang="en">Bass NM, Mullen KD, Sanyal A, et al. Rifaximin treatment in hepatic encephalopathy. N Engl J Med. 2010 Mar 25. 362 (12):1071-81.</mixed-citation></citation-alternatives></ref><ref id="cit28"><label>28</label><citation-alternatives><mixed-citation xml:lang="ru">Kircheis G, Nilius R, Held C, et al. Therapeutic efficacy of L-ornithine-L-aspartate infusions in patients with cirrhosis and hepatic encephalopathy: results of a placebo-controlled, double-blind study. Hepatology.1997 Jun. 25(6):1351-1360 DOI: 10.1002 / HEP.510250609 ID: 20483124.</mixed-citation><mixed-citation xml:lang="en">Kircheis G, Nilius R, Held C, et al. Therapeutic efficacy of L-ornithine-L-aspartate infusions in patients with cirrhosis and hepatic encephalopathy: results of a placebo-controlled, double-blind study. Hepatology.1997 Jun. 25(6):1351-1360 DOI: 10.1002 / HEP.510250609 ID: 20483124.</mixed-citation></citation-alternatives></ref><ref id="cit29"><label>29</label><citation-alternatives><mixed-citation xml:lang="ru">Dalal R., McGee R.G., Riordan S. M. et al. Probiotics for people with hepatic encephalopath. Cochrane Database Syst Rev. 2017, vol. 2: CD008716. DOI: 10.1002 / 14651858.CD008716.pub3.</mixed-citation><mixed-citation xml:lang="en">Dalal R., McGee R.G., Riordan S. M. et al. Probiotics for people with hepatic encephalopath. Cochrane Database Syst Rev. 2017, vol. 2: CD008716. DOI: 10.1002 / 14651858.CD008716.pub3.</mixed-citation></citation-alternatives></ref><ref id="cit30"><label>30</label><citation-alternatives><mixed-citation xml:lang="ru">Huda A., Newcomer R., Harrington C., Keeff e E.B., Esquivel C. O. Employment after liver transplantation: a review. Transplant Proc., 2015 vol. 47, pp. 233-239.</mixed-citation><mixed-citation xml:lang="en">Huda A., Newcomer R., Harrington C., Keeff e E.B., Esquivel C. O. Employment after liver transplantation: a review. Transplant Proc., 2015 vol. 47, pp. 233-239.</mixed-citation></citation-alternatives></ref><ref id="cit31"><label>31</label><citation-alternatives><mixed-citation xml:lang="ru">Herrero JI, Bilbao JI, Diaz ML, Alegre F, Inarrairaegui M, Pardo F, et al. Hepatic encephalopathy after liver transplantation in a patient with a normally functioning graft: treatment with embolization of portosystemic collaterals. Liver Transpl. 2009 v.15, pp. 111-114.</mixed-citation><mixed-citation xml:lang="en">Herrero JI, Bilbao JI, Diaz ML, Alegre F, Inarrairaegui M, Pardo F, et al. Hepatic encephalopathy after liver transplantation in a patient with a normally functioning graft: treatment with embolization of portosystemic collaterals. Liver Transpl. 2009 v.15, pp. 111-114.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
