Prin Meghan, Bakker Jan, Wagener Gebhard
Meghan Prin, Gebhard Wagener, Department of Anesthesiology, College of Physicians and Surgeons of Columbia University, New York, NY 10032, United States.
World J Gastroenterol. 2015 Mar 7;21(9):2582-92. doi: 10.3748/wjg.v21.i9.2582.
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.
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。
