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[一名心内膜心肌纤维化患者的缺氧性肝炎]

[Hypoxic hepatitis in a patient with endomyocardial fibrosis].

作者信息

Durlach Martín, Echavarría Gonzalo, Antonucci Ricardo, Arias Tamara, Pensa Lucila, Fadel Daniel

机构信息

área de Clínica Médica, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Argentina. E-mail:

área de Clínica Médica, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Argentina.

出版信息

Medicina (B Aires). 2019;79(4):284-286.

Abstract

Endomyocardial fibrosis is a restrictive cardiomyopathy with high morbidity and mortality rates, prevalent in the sub-Saharan Africa region but infrequent in our population. It has a close relation with blood hypereosinophilia. Hypoxic hepatitis is frequently observed in intensive care units and its diagnosis is clinical. It shows a typical enzyme pattern with high mortality too. There are multiple mechanisms responsible for this condition, such as ischemia, passive congestion and dysoxia. We described the case of a 35 year-old cocaine addict woman diagnosed with endomyocardial fibrosis and hypereosinophilic syndrome who developed cardiogenic shock with hypoxic hepatitis. The patient evolved favorably with the appropriate treatment.

摘要

心内膜心肌纤维化是一种发病率和死亡率较高的限制性心肌病,在撒哈拉以南非洲地区较为常见,但在我国人群中并不常见。它与血液嗜酸性粒细胞增多密切相关。缺氧性肝炎在重症监护病房中经常可见,其诊断主要依靠临床症状。它也呈现出典型的酶学模式,死亡率也很高。导致这种情况的机制有多种,如缺血、被动性充血和低氧血症。我们描述了一名35岁的可卡因成瘾女性病例,该患者被诊断为心内膜心肌纤维化和嗜酸性粒细胞增多综合征,并发展为心源性休克合并缺氧性肝炎。经过适当治疗,患者病情好转。

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