Questão de prova
Autor: Tatiana Bruder Lourenção | Publicado: 2012-02-18T08:51:00-08:00

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Pacientes com doenças hepáticas, especialmente apresentando quadros de encefalopatia, devem receber dieta pobre em:
a-&nbsp;&nbsp;&nbsp; Queijo e gema de ovob-&nbsp;&nbsp;&nbsp; Soja e macarrãoc-&nbsp;&nbsp;&nbsp;&nbsp;Farinha de trigo e milhod-&nbsp;&nbsp;&nbsp; Peixe congelado e leite de cabrae-&nbsp;&nbsp;&nbsp;&nbsp; Espinafre e berinjela
Resposta A.
A encefalopatia hepática (EH) é uma síndrome clínica que pode acometer 70% dos pacientes cirróticos. A EH caracteriza-se por disfunção do sistema nervoso central associado à falência hepato-portal, desencadeando distúrbios neurológicos que podem evoluir desde sonolência até o coma e morte. O objetivo dietoterápico nesta situação será reverter o quadro de EH através do controle da ingestão de proteínas. As proteínas de origem animal, ricas em aminoácidos de cadeia aromática (AACA- tirosina, fenilalanina, triptofano), devem ser restringidas da dieta desses pacientes porque produzem falsos neurotransmissores cerebrais, os quais poderiam ser uma das causas da EH. Portanto a opção dietoterápica foi o uso de aminoácidos de cadeia ramificada (AACR – valina, leucina, isoleucina), presentes nas proteínas vegetais, pois impedem a passagem dos AACA pela barreira hematoencefálica, reduzindo assim as alterações neurológicas que o paciente poderá apresentar. ainda o alto teor de fibra de uma dieta de proteína vegetal pode também desempenhar um papel na excreção de compostos nitrogenados. Foi proposto o uso de probióticos no tratamento da EH pela redução de amônia no sangue portal.