Yilmaz S, Dursum M, Canoruç F, Bayan K, Karabulut A, Akay H
Department of Gastroenterology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey.
Neth J Med. 2005 Dec;63(11):448-52.
The hepatopulmonary syndrome has been defined as chronic liver disease accompanied by abnormal pulmonary gas exchange, which might result in arterial deoxygenation, and widespread intrapulmonary vasodilation. Although it has been pointed out that hepatopulmonary syndrome occurs in liver cirrhosis, there are a few studies in the literature reporting noncirrhotic portal hypertension as a cause of hepatopulmonary syndrome. Currently, liver transplantation is the only effective therapy for such patients. on the other hand, there is also a proposal about considering paroxetine, a potent nitric oxide synthase inhibitor, for use in the hepatopulmonary syndrome. We present a patient with severe (type II) hepatopulmonary syndrome caused by idiopathic portal hypertension and discuss the consequences of paroxetine therapy.
肝肺综合征被定义为伴有异常肺气体交换的慢性肝病，这可能导致动脉脱氧以及广泛的肺内血管扩张。尽管已经指出肝肺综合征发生于肝硬化患者，但文献中仅有少数研究报道非肝硬化门静脉高压是肝肺综合征的一个病因。目前，肝移植是这类患者唯一有效的治疗方法。另一方面，也有提议考虑将强效一氧化氮合酶抑制剂帕罗西汀用于肝肺综合征的治疗。我们报告一例由特发性门静脉高压引起的重度（II型）肝肺综合征患者，并讨论帕罗西汀治疗的效果。
