[肝硬化所致发绀与杵状指的诊断]
[Diagnosis of cyanosis and digital clubbing caused by liver cirrhosis].
作者信息
Lu W X, Qian J M, Li L Y
机构信息
Peking Union Medical College Hospital, Beijing.
出版信息
Zhonghua Nei Ke Za Zhi. 1990 Feb;29(2):98-101, 126-7.
Six cases of cyanosis and digital clubbing caused by liver cirrhosis were reported. The mean levels of PaO2 and PaCO2 were 6.4 +/- 0.8 kPa (48.3 +/- 6.2 mmHg) and 3.9 +/- 0.8 kPa (29.5 +/- 6.1 mmHg) respectively. The cause of cyanosis and digital clubbing in liver cirrhosis was discussed. Abnormal intrapulmonary shunting (IPS), which was proved in 4 cases by whole-body radionuclide scanning with 99mTc-MAA, is suggested as the major cause of cyanosis in liver cirrhosis. Clinically IPS is usually associated with debilitating conditions characterized by hyperventilation, abnormality of lung diffusion and orthodeoxia or platypnea. The authors suggest that whole-body radionuclide scanning with 99mTc-MAA may be performed for establishing IPS if liver cirrhosis is highly suspected to be the cause of severe hypoxemia.
报告了6例由肝硬化引起的发绀和杵状指病例。动脉血氧分压（PaO2）和动脉血二氧化碳分压（PaCO2）的平均水平分别为6.4±0.8千帕（48.3±6.2毫米汞柱）和3.9±0.8千帕（29.5±6.1毫米汞柱）。对肝硬化中发绀和杵状指的病因进行了讨论。通过99mTc-MAA全身放射性核素扫描在4例中证实的异常肺内分流（IPS）被认为是肝硬化中发绀的主要原因。临床上，IPS通常与以通气过度、肺弥散异常和直立性低氧血症或平卧呼吸困难为特征的虚弱状况相关。作者建议，如果高度怀疑肝硬化是严重低氧血症的原因，可进行99mTc-MAA全身放射性核素扫描以确定IPS。
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