暴发性肝衰竭时的脑血流动力学和代谢变化

Cerebral hemodynamic and metabolic changes in fulminant hepatic failure.

作者信息

Paschoal Fernando Mendes, Nogueira Ricardo de Carvalho, Oliveira Marcelo de Lima, Paschoal Eric Homero Albuquerque, Teixeira Manoel Jacobsen, D'Albuquerque Luiz Augusto Carneiro, Bor-Seng-Shu Edson

机构信息

Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Divisão de Cirurgia Neurológica, Laboratório de Neurosonologia e Hemodinâmica Cerebral, São Paulo SP, Brasil.

Universidade Federal do Pará, Faculdade de Medicina, Universidade Federal do Pará, Belém PA, Brasil.

出版信息

Arq Neuropsiquiatr. 2017 Jul;75(7):470-476. doi: 10.1590/0004-282X20170076.

DOI:10.1590/0004-282X20170076

PMID:28746435

Abstract

Intracranial hypertension and brain swelling are a major cause of morbidity and mortality of patients suffering from fulminant hepatic failure (FHF). The pathogenesis of these complications has been investigated in man, in experimental models and in isolated cell systems. Currently, the mechanism underlying cerebral edema and intracranial hypertension in the presence of FHF is multi-factorial in etiology and only partially understood. The aim of this paper is to review the pathophysiology of cerebral hemodynamic and metabolism changes in FHF in order to improve understanding of intracranial dynamics complication in FHF.

摘要

颅内高压和脑肿胀是暴发性肝衰竭（FHF）患者发病和死亡的主要原因。这些并发症的发病机制已在人体、实验模型和分离细胞系统中进行了研究。目前，FHF情况下脑水肿和颅内高压的潜在机制在病因学上是多因素的，并且仅得到部分理解。本文的目的是综述FHF时脑血流动力学和代谢变化的病理生理学，以增进对FHF颅内动力学并发症的理解。