Yeshua Hanny, Blendis Laurie M, Oren Ran
Department of Gastroenterology, Tel Aviv Sourasky Medical Center, Clalit Health Services, and the Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel.
Semin Cardiothorac Vasc Anesth. 2009 Mar;13(1):60-9. doi: 10.1177/1089253209334615. Epub 2009 Mar 31.
Respiratory problems are common in patients with chronic liver diseases. The most common causes are disorders that are not related to liver diseases such as asthma and COPD. In addition certain liver diseases that are associated with specific pulmonary abnormalities, and conditions associated with end stage liver disease like tense ascites and intercostal muscular wasting are considered. Finally two unique disorders characterizing by vascular abnormalities independent of cardiorespiratory disorder-the hepatopulmonary syndrome (HPS) and portopulmonary hypertension (POPH) are observed. These disorders have different pathogenesis, different clinical pictures, treatment and prognosis. This article reviews the epidemiology, pathophysiology, clinical features, evaluation and current therapy of these two disorders.
呼吸问题在慢性肝病患者中很常见。最常见的原因是与肝脏疾病无关的疾病,如哮喘和慢性阻塞性肺疾病(COPD)。此外,还考虑了某些与特定肺部异常相关的肝脏疾病,以及与终末期肝病相关的情况,如张力性腹水和肋间肌萎缩。最后,观察到两种以独立于心肺疾病的血管异常为特征的独特疾病——肝肺综合征(HPS)和门脉性肺动脉高压(POPH)。这些疾病具有不同的发病机制、临床表现、治疗方法和预后。本文综述了这两种疾病的流行病学、病理生理学、临床特征、评估和当前治疗方法。