肝衰引起脑病是个值得注意的问题。一般认为氨的增加是脑病的发展和严重肝脏病人昏迷的主要原因。进入脑中的大部分氨,将谷氨酸酰胺化而生成谷氨酰胺。骨骼肌将血流中的氨生成谷氨酰胺。在高氨血症,由脑、骨骼肌和其他组织合成谷氨酰胺,是身体解毒去氨的主要机制。脑内氨增加引起神经损伤时,解毒作用系统则可能成为实际有用的途径。所谓肝昏迷的Kreb氏循环缺失学说认为,由于谷氨酸酰胺化作用而使Kreb氏循环的中间产物 Encephalopathy caused by liver failure is a noteworthy issue. It is generally believed that the increase of ammonia is the main reason for the development of encephalopathy and coma of severe liver patients. Into the brain most of the ammonia, glutamate is amidated to produce glutamine. Skeletal muscle produces ammonia in the bloodstream of glutamine. In hyperammonemia, synthesis of glutamine from the brain, skeletal muscle and other tissues is the main mechanism of detoxification to the body. When brain damage is caused by increased ammonia in the brain, detoxification systems can become a practical and useful way. The so-called hepatic coma Kreb’s cycle of lack of theory that, due to glutamate amidation and Kreb cycle intermediates