終末期肝硬變的心血管系統并發癥及其臨床意義_《中國普外基礎與臨床雜志》

作者：

董剛 , 任波 , 徐晨

中國人民解放軍第三○二醫院麻醉科(北京 100039);

關鍵詞：

肝硬變心血管血流動力學并發癥

視頻：

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摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　介紹終末期肝硬變時心血管系統的病理生理變化及其臨床意義。
方法　復習和總結了相關文獻資料并作綜述。
結果　肝硬變時體液和神經功能失調引起血流動力學的異常改變，循環調節功能、體液分布和心臟功能都受到不同程度的影響。
結論　了解肝硬變時心血管系統的并發癥對指導終末期肝硬變的治療具有積極的意義。

引用本文： 董剛,任波,徐晨. 終末期肝硬變的心血管系統并發癥及其臨床意義. 中國普外基礎與臨床雜志, 2010, 17(4): 411-412. doi: 復制

1.	Mller S, Henriksen JH. Cardiovascular complications of cirrhosis [J]. Postgrad Med J， 2009; 85(999): 44-54.
2.	葉樂馳, 張啟瑜. 門靜脈高壓癥內臟血管擴張機制的研究進展 [J]. 國際外科學雜志， 2006; 33(1)： 7-11.
3.	Henriksen JH, Mller S. Cardiac and systemic haemodynamic complications of liver cirrhosis [J]. Scand Cardiovasc J，2009; 43(4): 218-225.
4.	La Villa G, Gentilini P. Hemodynamic alterations in liver cirrhosis [J]. Mol Aspects Med, 2008; 29(1-2): 112-118.
5.	Large DA, Shah VH. Nitric oxide and portal hypertension: interface of vasoreactivity and angiogenesis [J]. J Hepatol, 2006; 44(1): 209-216.
6.	Dümcke CW, Mller S. Autonomic dysfunction in cirrhosis and portal hypertension [J]. Scand J Clin Lab Invest, 2008; 68(6): 437-447.
7.	Henriksen JH, Fuglsang S, Bendtsen F, et al. Arterial compliance in patients with cirrhosis： stroke volume-pulse pressure ratio as simplified index [J]. Am J Physiol, 2001; 280(4): G584-G594.
8.	Mller S, Henriksen JH. Cardiopulmonary complications in chronic liver disease [J]. World J Gastroenterol, 2006; 12(4): 526-538.
9.	Brinch K, Mller S, Bendtsen F, et al. Plasma volume expansion by albumin in cirrhosis. Relation to blood volume distribution, arterial compliance and severity of disease [J]. J Hepatol, 2003; 39(1): 24-31.
10.	Henriksen JH, Mller S, Schifter S, et al. High arterial compliance in cirrhosis is related to low adrenaline and elevated circulating calcitonin gene related peptide but not to activated vasoconstrictor systems [J]. Gut, 2001; 49(1): 112-118.
11.	Mller S, Hansen EF, Becker U, et al. Central and systemic haemodynamic effects of terlipressin in portal hypertensive patients [J]. Liver, 2000; 20(1): 51-59.
12.	Gines P, Arroyo V, Rodes J, et al. Ascites and renal dysfunction in liver disease: Pathogenesis, Diagnosis, and Treatment [M]. 2nd Ed. Malden: Blackwell, 2005: 139-155.
13.	Ferlitsch A, plainer J, Mittermayer F, et al. Vasoconstrictor hyporeactivity can be reversed by antioxidants in patients with advanced alcoholic cirrhosis of the liver and ascites [J]. Crit Care Med, 2005; 33(9): 2028-2033.
14.	Lhuillier F, Dalmas ED, Gratadour PM, et al. Spontaneous baroreflex cardiac sensitivity in end-stage liver disease: effect of liver transplantation [J]. Eur J Anaesthesiol, 2006; 23(5): 426-432.
15.	Trevisani F, Sica G, Mainquà P, et al. Autonomic dysfunction and hyperdynamic circulation in cirrhosis with ascites [J]. Hepatology, 1999; 30(6): 1387-1392.
16.	Laffi G, Barletta G, La Villa G, et al. Altered cardiovascular responsiveness to active tilting in nonalcoholic cirrhosis [J]. Gastroenterology, 1997; 113(3): 891-898.
17.	Grose RD, Nolan J, Dillon JF, et al. Exercise-induced left ventricular dysfunction in alcoholic and non-alcoholic cirrhosis [J]. J Hepatol, 1995; 22(3): 326-332.
18.	Epstein SK, Ciubotaru RL, Zilberberg MD, et al. Analysis of impaired exercise capacity in patients with cirrhosis [J]. Dig Dis Sci, 1998; 43(8): 1701-1707.
19.	La Villa G, Barletta G, Romanelli RG, et al. Cardiovascular effects of canrenone in patients with preascitic cirrhosis [J]. Hepatology, 2002; 35(6): 1441-1448.
20.	Halliwill JR, Minson CT. Effect of hypoxia on arterial baroreflex control of heart rate and muscle sympathetic nerve activity in humans [J]. J Appl Physiol, 2002; 93(3): 857-864.
21.	Frith J, Newton JL. Autonomic dysfunction in chronic liver disease [J]. Liver Int, 2009; 29(4): 483-489.
22.	Iwakiri Y, Groszmann RJ. The hyperdynamic circulation of chronic liver diseases: from the patient to the molecule [J]. Hepatology, 2006; 43(2 Suppl 1): S121-S131.
23.	Ginès P, Guevara M, De Las Heras D, et al. Review article: albumin for circulatory support in patients with cirrhosis [J]. Aliment Pharmacol Ther, 2002; 16(Suppl 5): 24-31.
24.	Sola-Vera J, Miana J, Ricart E, et al. Randomized trial comparing albumin and saline in the prevention of paracentesis-induced circulatory dysfunction in cirrhotic patients with ascites [J]. Hepatology, 2003; 37(5): 1147-1153.
25.	Moreau R, Asselah T, Condat B, et al. Comparison of the effect of terlipressin and albumin on arterial blood volume in patients with cirrhosis and tense ascites treated by paracentesis: a randomised pilot study [J]. Gut, 2002; 50(1): 90-94.
26.	Singh V, Kumar B, Nain CK, et al. Noradrenaline and albumin in paracentesis-induced circulatory dysfunction in cirrhosis: a randomized pilot study [J]. J Intern Med, 2006; 260(1): 62-68.
27.	Mller S, Sndergaard L, Mgelvang J, et al. Decreased right heart blood volume determined by magnetic resonance imaging: evidence of central underfilling in cirrhosis [J]. Hepatology, 1995; 22(2): 472-478.
28.	Baik SK, Fouad TR, Lee SS. Cirrhotic cardiomyopathy [J]. Orphanet J Rare Dis, 2007; 27: 2-15.
29.	Wong F. Cirrhotic cardiomyopathy [J]. Hepatol Int, 2009; 3(1): 294-304.
30.	Liu H, Gaskari SA, Lee SS. Cardiac and vascular changes in cirrhosis: pathogenic echanisms [J]. World J Gastroenterol, 2006; 12(6): 837-842.
31.	Wong F, Girgrah N, Graba J, et al. The cardiac response to exercise in cirrhosis [J]. Gut, 2001; 49(2): 268-275.
32.	Ginès P, Uriz J, Calahorra B, et al. Transjugular intrahepatic portosystemic shunting versus paracentesis plus albumin for refractory ascites in cirrhosis [J].Gastroenterology, 2002; 123(6): 1839-1847.
33.	Mller S, Dümcke CW, Krag A. The heart and the liver [J]. Expert Rev Gastroenterol Hepatol, 2009; 3(1): 51-64.
34.	Arroyo V, Fernandez J, Ginès P. Pathogenesis and treatment of hepatorenal syndrome [J]. Semin Liver Dis, 2008; 28(1): 81-95.
35.	Zambruni A, Trevisani F, Caraceni P, et al. Cardiac electrophysiological abnormalities in patients with cirrhosis [J]. J Hepatol, 2006; 44(5): 994-1002.
36.	陳峰松, 趙建妹. 肝硬變心肌病研究進展 [J]. 中國臨床新醫學, 2009; 2(1): 102-105.
37.	孫福榮, 王炳元. 肝硬化性心肌病 [J]. 胃腸病學和肝病學雜志, 2009; 18(4): 287-290.

1. Mller S, Henriksen JH. Cardiovascular complications of cirrhosis [J]. Postgrad Med J， 2009; 85(999): 44-54.
2. 　葉樂馳, 張啟瑜. 門靜脈高壓癥內臟血管擴張機制的研究進展 [J]. 國際外科學雜志， 2006; 33(1)： 7-11.
3. 　Henriksen JH, Mller S. Cardiac and systemic haemodynamic complications of liver cirrhosis [J]. Scand Cardiovasc J，2009; 43(4): 218-225.
4. 　La Villa G, Gentilini P. Hemodynamic alterations in liver cirrhosis [J]. Mol Aspects Med, 2008; 29(1-2): 112-118.
5. 　Large DA, Shah VH. Nitric oxide and portal hypertension: interface of vasoreactivity and angiogenesis [J]. J Hepatol, 2006; 44(1): 209-216.
6. 　Dümcke CW, Mller S. Autonomic dysfunction in cirrhosis and portal hypertension [J]. Scand J Clin Lab Invest, 2008; 68(6): 437-447.
7. 　Henriksen JH, Fuglsang S, Bendtsen F, et al. Arterial compliance in patients with cirrhosis： stroke volume-pulse pressure ratio as simplified index [J]. Am J Physiol, 2001; 280(4): G584-G594.
8. 　Mller S, Henriksen JH. Cardiopulmonary complications in chronic liver disease [J]. World J Gastroenterol, 2006; 12(4): 526-538.
9. 　Brinch K, Mller S, Bendtsen F, et al. Plasma volume expansion by albumin in cirrhosis. Relation to blood volume distribution, arterial compliance and severity of disease [J]. J Hepatol, 2003; 39(1): 24-31.
10. 　Henriksen JH, Mller S, Schifter S, et al. High arterial compliance in cirrhosis is related to low adrenaline and elevated circulating calcitonin gene related peptide but not to activated vasoconstrictor systems [J]. Gut, 2001; 49(1): 112-118.
11. 　Mller S, Hansen EF, Becker U, et al. Central and systemic haemodynamic effects of terlipressin in portal hypertensive patients [J]. Liver, 2000; 20(1): 51-59.
12. 　Gines P, Arroyo V, Rodes J, et al. Ascites and renal dysfunction in liver disease: Pathogenesis, Diagnosis, and Treatment [M]. 2nd Ed. Malden: Blackwell, 2005: 139-155.
13. 　Ferlitsch A, plainer J, Mittermayer F, et al. Vasoconstrictor hyporeactivity can be reversed by antioxidants in patients with advanced alcoholic cirrhosis of the liver and ascites [J]. Crit Care Med, 2005; 33(9): 2028-2033.
14. 　Lhuillier F, Dalmas ED, Gratadour PM, et al. Spontaneous baroreflex cardiac sensitivity in end-stage liver disease: effect of liver transplantation [J]. Eur J Anaesthesiol, 2006; 23(5): 426-432.
15. 　Trevisani F, Sica G, Mainquà P, et al. Autonomic dysfunction and hyperdynamic circulation in cirrhosis with ascites [J]. Hepatology, 1999; 30(6): 1387-1392.
16. 　Laffi G, Barletta G, La Villa G, et al. Altered cardiovascular responsiveness to active tilting in nonalcoholic cirrhosis [J]. Gastroenterology, 1997; 113(3): 891-898.
17. 　Grose RD, Nolan J, Dillon JF, et al. Exercise-induced left ventricular dysfunction in alcoholic and non-alcoholic cirrhosis [J]. J Hepatol, 1995; 22(3): 326-332.
18. 　Epstein SK, Ciubotaru RL, Zilberberg MD, et al. Analysis of impaired exercise capacity in patients with cirrhosis [J]. Dig Dis Sci, 1998; 43(8): 1701-1707.
19. 　La Villa G, Barletta G, Romanelli RG, et al. Cardiovascular effects of canrenone in patients with preascitic cirrhosis [J]. Hepatology, 2002; 35(6): 1441-1448.
20. 　Halliwill JR, Minson CT. Effect of hypoxia on arterial baroreflex control of heart rate and muscle sympathetic nerve activity in humans [J]. J Appl Physiol, 2002; 93(3): 857-864.
21. 　Frith J, Newton JL. Autonomic dysfunction in chronic liver disease [J]. Liver Int, 2009; 29(4): 483-489.
22. 　Iwakiri Y, Groszmann RJ. The hyperdynamic circulation of chronic liver diseases: from the patient to the molecule [J]. Hepatology, 2006; 43(2 Suppl 1): S121-S131.
23. 　Ginès P, Guevara M, De Las Heras D, et al. Review article: albumin for circulatory support in patients with cirrhosis [J]. Aliment Pharmacol Ther, 2002; 16(Suppl 5): 24-31.
24. 　Sola-Vera J, Miana J, Ricart E, et al. Randomized trial comparing albumin and saline in the prevention of paracentesis-induced circulatory dysfunction in cirrhotic patients with ascites [J]. Hepatology, 2003; 37(5): 1147-1153.
25. 　 Moreau R, Asselah T, Condat B, et al. Comparison of the effect of terlipressin and albumin on arterial blood volume in patients with cirrhosis and tense ascites treated by paracentesis: a randomised pilot study [J]. Gut, 2002; 50(1): 90-94.
26. 　Singh V, Kumar B, Nain CK, et al. Noradrenaline and albumin in paracentesis-induced circulatory dysfunction in cirrhosis: a randomized pilot study [J]. J Intern Med, 2006; 260(1): 62-68.
27. 　Mller S, Sndergaard L, Mgelvang J, et al. Decreased right heart blood volume determined by magnetic resonance imaging: evidence of central underfilling in cirrhosis [J]. Hepatology, 1995; 22(2): 472-478.
28. 　Baik SK, Fouad TR, Lee SS. Cirrhotic cardiomyopathy [J]. Orphanet J Rare Dis, 2007; 27: 2-15.
29. 　Wong F. Cirrhotic cardiomyopathy [J]. Hepatol Int, 2009; 3(1): 294-304.
30. 　Liu H, Gaskari SA, Lee SS. Cardiac and vascular changes in cirrhosis: pathogenic echanisms [J]. World J Gastroenterol, 2006; 12(6): 837-842.
31. 　Wong F, Girgrah N, Graba J, et al. The cardiac response to exercise in cirrhosis [J]. Gut, 2001; 49(2): 268-275.
32. 　Ginès P, Uriz J, Calahorra B, et al. Transjugular intrahepatic portosystemic shunting versus paracentesis plus albumin for refractory ascites in cirrhosis [J].Gastroenterology, 2002; 123(6): 1839-1847.
33. 　Mller S, Dümcke CW, Krag A. The heart and the liver [J]. Expert Rev Gastroenterol Hepatol, 2009; 3(1): 51-64.
34. 　Arroyo V, Fernandez J, Ginès P. Pathogenesis and treatment of hepatorenal syndrome [J]. Semin Liver Dis, 2008; 28(1): 81-95.
35. 　Zambruni A, Trevisani F, Caraceni P, et al. Cardiac electrophysiological abnormalities in patients with cirrhosis [J]. J Hepatol, 2006; 44(5): 994-1002.
36. 　陳峰松, 趙建妹. 肝硬變心肌病研究進展 [J]. 中國臨床新醫學, 2009; 2(1): 102-105.
37. 　孫福榮, 王炳元. 肝硬化性心肌病 [J]. 胃腸病學和肝病學雜志, 2009; 18(4): 287-290.

《中國普外基礎與臨床雜志》

終末期肝硬變的心血管系統并發癥及其臨床意義

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

《中國普外基礎與臨床雜志》

終末期肝硬變的心血管系統并發癥及其臨床意義

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料