肝硬化和脓毒症中的肝内脏循环
Hepatosplanchnic circulation in cirrhosis and sepsis.
作者信息
Prin Meghan, Bakker Jan, Wagener Gebhard
机构信息
Meghan Prin, Gebhard Wagener, Department of Anesthesiology, College of Physicians and Surgeons of Columbia University, New York, NY 10032, United States.
出版信息
World J Gastroenterol. 2015 Mar 7;21(9):2582-92. doi: 10.3748/wjg.v21.i9.2582.
Abstract
Hepatosplanchnic circulation receives almost half of cardiac output and is essential to physiologic homeostasis. Liver cirrhosis is estimated to affect up to 1% of populations worldwide, including 1.5% to 3.3% of intensive care unit patients. Cirrhosis leads to hepatosplanchnic circulatory abnormalities and end-organ damage. Sepsis and cirrhosis result in similar circulatory changes and resultant multi-organ dysfunction. This review provides an overview of the hepatosplanchnic circulation in the healthy state and in cirrhosis, examines the signaling pathways that may play a role in the physiology of cirrhosis, discusses the physiology common to cirrhosis and sepsis, and reviews important issues in management.
摘要
肝内脏循环接受几乎一半的心输出量，对生理稳态至关重要。据估计，肝硬化影响全球多达1%的人口，包括1.5%至3.3%的重症监护病房患者。肝硬化导致肝内脏循环异常和终末器官损害。脓毒症和肝硬化会导致类似的循环变化以及由此产生的多器官功能障碍。本综述概述了健康状态和肝硬化状态下的肝内脏循环，研究了可能在肝硬化生理过程中起作用的信号通路，讨论了肝硬化和脓毒症共有的生理学问题，并综述了管理中的重要问题。
相似文献
1
Hepatosplanchnic circulation in cirrhosis and sepsis.肝硬化和脓毒症中的肝内脏循环
World J Gastroenterol. 2015 Mar 7;21(9):2582-92. doi: 10.3748/wjg.v21.i9.2582.
2
Hepatic circulation in cirrhosis.肝硬化中的肝循环。
Clin Gastroenterol. 1985 Jan;14(1):155-68.
3
Portal and splanchnic hemodynamics after partial splenic embolization in cirrhotic patients with hypersplenism.肝硬化脾功能亢进患者部分脾栓塞术后的门静脉和内脏血流动力学
APMIS. 2015 Dec;123(12):1032-9. doi: 10.1111/apm.12470.
4
Hepatic vascular changes in human and experimental cirrhosis.人类及实验性肝硬化中的肝血管变化
J Pathol Bacteriol. 1966 Oct;92(2):405-14. doi: 10.1002/path.1700920219.
5
Systemic and splanchnic hemodynamic changes after liver transplantation for cirrhosis: a long-term prospective study.肝硬化肝移植术后全身及内脏血流动力学变化：一项长期前瞻性研究。
Hepatology. 1999 Jul;30(1):58-64. doi: 10.1002/hep.510300112.
6
[Changes in hemodynamics and angioarchitecture of the hepatolienal basin after embolization of the splenic artery in liver cirrhosis].[肝硬化患者脾动脉栓塞术后肝脾区血流动力学及血管构筑的变化]
Vestn Khir Im I I Grek. 1989 Feb;142(2):24-7.
7
[The effect of hepatosplanchnic circulation in treatment of trauma and sepsis. Beyond O2-supply O2-uptake relationship?].[肝脾循环在创伤和脓毒症治疗中的作用。超越氧供与氧摄取关系？]
Anaesthesist. 2000 May;49(5):451-4. doi: 10.1007/s001010070114.
8
Nitrate kinetics in patients with compensated cirrhosis: correlation with hemodynamics.代偿期肝硬化患者的硝酸盐动力学：与血流动力学的相关性
Am J Gastroenterol. 1996 Oct;91(10):2190-4.
9
The effect of hemorrhage on hepatosplanchnic hemodynamics, liver function and hepatic metabolism.出血对肝脾血流动力学、肝功能及肝脏代谢的影响。
Acta Physiol Scand. 1973 Oct;89(2):269-77. doi: 10.1111/j.1748-1716.1973.tb05519.x.
10
[Hemodynamic studies on liver circulation with special reference to the hepatic artery].[肝脏循环的血流动力学研究，特别提及肝动脉]
Fortschr Med. 1977 Jul 21;95(27):1741-4.
引用本文的文献
1
Correlations of three scoring systems with the prognosis of patients with liver cirrhosis complicated with sepsis syndrome.三种评分系统与肝硬化合并脓毒症综合征患者预后的相关性
World J Gastrointest Surg. 2025 Mar 27;17(3):99570. doi: 10.4240/wjgs.v17.i3.99570.
2
L-distance ratio: a new distance ratio-based evaluation method for the diagnosis of cirrhosis using enhanced computed tomography.L距离比：一种基于距离比的新型增强计算机断层扫描诊断肝硬化评估方法。
Quant Imaging Med Surg. 2023 Mar 1;13(3):1499-1509. doi: 10.21037/qims-22-861. Epub 2023 Jan 9.
3
Synapomorphic features of hepatic and pulmonary vasculatures include comparable purinergic signaling responses in host defense and modulation of inflammation.肝和肺脉管系统的共有特征包括在宿主防御和炎症调节中可比的嘌呤能信号转导反应。
Am J Physiol Gastrointest Liver Physiol. 2021 Aug 1;321(2):G200-G212. doi: 10.1152/ajpgi.00406.2020. Epub 2021 Jun 9.
4
Oxidative Stress in Chronic Liver Disease and Portal Hypertension: Potential of DHA as Nutraceutical.慢性肝病和门静脉高压症中的氧化应激：DHA 作为营养保健品的潜力。
Nutrients. 2020 Aug 28;12(9):2627. doi: 10.3390/nu12092627.
5
The impact of short-term machine perfusion on the risk of cancer recurrence after rat liver transplantation with donors after circulatory death.在大鼠原位肝移植中，应用体外循环死亡供肝对短期机器灌注对癌症复发风险的影响。
PLoS One. 2019 Nov 25;14(11):e0224890. doi: 10.1371/journal.pone.0224890. eCollection 2019.
6
Challenge to the Intestinal Mucosa During Sepsis.脓毒症时的肠道黏膜挑战。
Front Immunol. 2019 Apr 30;10:891. doi: 10.3389/fimmu.2019.00891. eCollection 2019.
7
Immune Dysfunction and Albumin-Related Immunity in Liver Cirrhosis.肝硬化中的免疫功能障碍和白蛋白相关免疫。
Mediators Inflamm. 2019 Feb 25;2019:7537649. doi: 10.1155/2019/7537649. eCollection 2019.
8
The digestive tract as the origin of systemic inflammation.消化道作为全身炎症的起源。
Crit Care. 2016 Oct 18;20(1):279. doi: 10.1186/s13054-016-1458-3.
9
Evaluation of liver function and electroacupuncture efficacy of animals with alcoholic liver injury by the novel imaging methods.用新型成像方法评估酒精性肝损伤动物的肝功能及电针疗效。
Sci Rep. 2016 Jul 22;6:30119. doi: 10.1038/srep30119.
10
Acute-on-chronic liver failure: Pathogenesis, prognostic factors and management.急性-on-慢性肝衰竭：发病机制、预后因素及管理。
注：原文中“Acute-on-chronic”表述不太准确，可能是“acute-on-chronic”，准确意思是“慢加急性”。完整准确译文应该是：慢加急性肝衰竭：发病机制、预后因素及管理。
World J Gastroenterol. 2015 Nov 14;21(42):12125-40. doi: 10.3748/wjg.v21.i42.12125.
本文引用的文献
1
Epidemiology and outcomes of bloodstream infection in patients with cirrhosis.肝硬化患者血流感染的流行病学和结局。
J Hepatol. 2014 Jul;61(1):51-8. doi: 10.1016/j.jhep.2014.03.021. Epub 2014 Mar 26.
2
Impact of infection on the prognosis of critically ill cirrhotic patients: results from a large worldwide study.感染对重症肝硬化患者预后的影响：一项大型全球研究的结果
Liver Int. 2014 Nov;34(10):1496-503. doi: 10.1111/liv.12520. Epub 2014 Mar 26.
3
The Royal Free Hospital score: a calibrated prognostic model for patients with cirrhosis admitted to intensive care unit. Comparison with current models and CLIF-SOFA score.皇家自由医院评分：一种针对 ICU 收治的肝硬化患者的校准预后模型。与现有模型和 CLIF-SOFA 评分的比较。
Am J Gastroenterol. 2014 Apr;109(4):554-62. doi: 10.1038/ajg.2013.466. Epub 2014 Feb 4.
4
5
Epidemiology of severe sepsis.严重脓毒症的流行病学。
Virulence. 2014 Jan 1;5(1):4-11. doi: 10.4161/viru.27372. Epub 2013 Dec 11.
6
Outcome of patients with cirrhosis requiring mechanical ventilation in ICU.ICU 中需要机械通气的肝硬化患者的转归。
J Hepatol. 2014 Mar;60(3):570-8. doi: 10.1016/j.jhep.2013.11.012. Epub 2013 Nov 23.
7
Impact of chronic liver disease in intensive care unit acquired pneumonia: a prospective study.重症监护病房获得性肺炎中慢性肝病的影响：一项前瞻性研究。
Intensive Care Med. 2013 Oct;39(10):1776-84. doi: 10.1007/s00134-013-3025-6. Epub 2013 Aug 2.
8
Activation of the MAS receptor by angiotensin-(1-7) in the renin-angiotensin system mediates mesenteric vasodilatation in cirrhosis.血管紧张素转化酶 2 抑制剂对肝硬化大鼠肠系膜动脉血管张力及自发性高血压大鼠血压的影响
Gastroenterology. 2013 Oct;145(4):874-884.e5. doi: 10.1053/j.gastro.2013.06.036. Epub 2013 Jun 22.
9
Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis.急性慢性肝衰竭是一种独特的综合征，发生在肝硬化急性失代偿的患者中。
Gastroenterology. 2013 Jun;144(7):1426-37, 1437.e1-9. doi: 10.1053/j.gastro.2013.02.042. Epub 2013 Mar 6.
10
Cirrhotic patients in the ICU: prognostic markers and outcome.ICU 中的肝硬化患者：预后标志物和结果。
Curr Opin Crit Care. 2013 Apr;19(2):154-60. doi: 10.1097/MCC.0b013e32835f0c17.
Zotero 插件