Kisloff B, Schaffer G
Am J Dig Dis. 1976 Oct;21(10):895-900. doi: 10.1007/BF01072084.
An elderly female with an acute episode of congestive heart failure, unaccompanied by any periods of hypotension, developed fulminant hepatic failure with an accompanying coagulopathy. Attempts to establish an etiology for her acute hepatic insufficiency, other than cardiac failure, proved negative. Fulminant hepatic failure as a consequence of congestive heart failure, without prolonged periods of hypotension preceding alteration in hepatic function, has not heretofore been described. Liver function is adversely effected in congestive heart failure. Hepatic ammonia clearance is impaired in cardiac failure and may be diminished to the point of resulting in hepatic encephalopathy. Coagulopathy is a frequent concomitant of fulminant hepatic failure. Establishing a clear etiology for a coagulopathy in the face of concomitant liver disease is difficult, thus making any therapeutic intervention fraught with peril.
一名老年女性发生急性充血性心力衰竭，未伴有任何低血压期，随后发展为暴发性肝衰竭并伴有凝血病。除心力衰竭外，试图确定其急性肝功能不全病因的检查结果均为阴性。此前尚未有过因充血性心力衰竭导致暴发性肝衰竭而在肝功能改变之前未出现长时间低血压的报道。充血性心力衰竭会对肝功能产生不利影响。心力衰竭时肝氨清除功能受损，可能会降低到导致肝性脑病的程度。凝血病是暴发性肝衰竭常见的伴随症状。在伴有肝脏疾病的情况下，明确凝血病的病因很困难，因此任何治疗干预都充满风险。
