— 生理適應 · EASY · MCQ —
末期肝硬化病人發生肝性腦病變。哪項檢驗值可解釋其意識狀態改變？
A client with advanced cirrhosis has developed hepatic encephalopathy. Which laboratory value explains the client's altered mental status?
- ADecreased serum albumin血清白蛋白降低
- BElevated serum ammonia✓ 正解血清氨升高
- CElevated ALT and ASTALT 和 AST 升高
- DElevated serum bilirubin血清膽紅素升高
— Explanation · 中文詳解 —
肝性腦病變的主因是肝臟無法將氨（Ammonia）轉化為尿素，導致血氨升高。氨能穿過血腦屏障，對中樞神經產生毒性，引起意識混亂。膽紅素（D）引起黃疸；白蛋白低（A）引起腹水；肝功能指標高（C）僅代表肝細胞受損。
Hepatic encephalopathy is primarily caused by the liver's inability to convert ammonia into urea, leading to elevated serum ammonia levels. Ammonia is a neurotoxin that crosses the blood-brain barrier, causing central nervous system toxicity and altered mental status.
✦ 台美臨床差異
無差異。血氨監測是診斷與追蹤肝性腦病變的標準。