Mocarzel Luis, Lanzieri Pedro, Nascimento Juliana, Peixoto Clara, Ribeiro Mário, Mesquita Evandro
Department of Internal Medicine, Hospital Universitário Antônio Pedro (HUAP), Universidade Federal Fluminense (UFF), Rua Marquês de Paraná 303, 7° Andar, Centro, 24033-900 Niterói, RJ, Brazil.
Department of Echocardiography, Hospital Universitário Antônio Pedro (HUAP), Universidade Federal Fluminense (UFF), Rua Marquês de Paraná 303, 7° Andar, Centro, 24033-900 Niterói, RJ, Brazil.
Case Reports Hepatol. 2015;2015:573513. doi: 10.1155/2015/573513. Epub 2015 Mar 22.
The hepatorenal syndrome (HRS) is defined as a potentially reversible kidney failure in patients with cirrhosis and ascites. An association of HRS and cirrhotic cardiomyopathy has been reported recently, but there are no result studies about the use of positive inotropes as part of the acute phase treatment. We report the case of a patient diagnosed with HRS, with high levels of NT pro-BNP, but with normal ejection fraction of the left ventricle, which showed abnormalities in systolic function through speckle tracking in echocardiography, reversible after the infusion of dobutamine. The patient showed clinical and laboratory improvement of his renal function after the infusion of dobutamine. Clinical studies are needed on HRS therapeutic approach taking into account the myocardial dysfunction as a major contributing factor to renal dysfunction.
肝肾综合征（HRS）被定义为肝硬化和腹水患者中潜在可逆的肾衰竭。最近有报道称HRS与肝硬化性心肌病有关，但尚无关于使用正性肌力药物作为急性期治疗一部分的研究结果。我们报告了一例被诊断为HRS的患者，其NT-proBNP水平升高，但左心室射血分数正常，经超声心动图斑点追踪显示其收缩功能异常，在输注多巴酚丁胺后可逆。该患者在输注多巴酚丁胺后肾功能在临床和实验室检查方面均有改善。需要针对HRS的治疗方法开展临床研究，将心肌功能障碍视为导致肾功能障碍的主要因素。
