Department of Medical Gastroenterology, Hvidovre Hospital, Faculty of Health Sciences, University of Copenhagen, Denmark.
Med Hypotheses. 2012 Jul;79(1):53-5. doi: 10.1016/j.mehy.2012.03.032. Epub 2012 Apr 24.
A considerable number of patients with advanced cirrhosis develop a hepatorenal syndrome. The pathogenesis involves liver dysfunction, splanchnic vasodilatation, and activation of vasoconstrictive systems. There are now several observations that indicate a relation between the renal failure and impaired cardiac function in patients with advanced cirrhosis. Cirrhotic cardiomyopathy has been described as a condition with impaired contractile responsiveness to stress and altered diastolic relaxation. We propose a cardiorenal interaction in patients with advanced cirrhosis and renal dysfunction that refers to a condition where cardiac dysfunction in cirrhosis is a major determinant of kidney function and survival. Thus, the relation between cardiac dysfunction and renal insufficiency should be target for future studies and development of new treatments should focus on ameliorating the cardiac dysfunction.
相当数量的晚期肝硬化患者会发展为肝肾综合征。其发病机制涉及肝功能障碍、内脏血管舒张和血管收缩系统的激活。现在有一些观察结果表明，在晚期肝硬化患者中，肾衰竭和心脏功能受损之间存在一定关系。肝硬化心肌病被描述为一种对压力的收缩反应能力受损和舒张期松弛改变的病症。我们提出了晚期肝硬化和肾功能障碍患者的心肾相互作用，指的是肝硬化中心脏功能障碍是肾功能和生存的主要决定因素的一种情况。因此，心脏功能障碍与肾功能不全之间的关系应该是未来研究的目标，新治疗方法的开发应侧重于改善心脏功能障碍。
