Møller Søren, Kimer Nina, Barløse Mads, Bendtsen Flemming
Department Clinical Physiology and Nuclear Medicine, Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Hvidovre, Denmark.
Gastro Unit, Medical Division, Hvidovre Hospital, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Scand J Gastroenterol. 2020 Apr;55(4):383-394. doi: 10.1080/00365521.2020.1744709. Epub 2020 Apr 1.
Detailed knowledge and understanding of the pathophysiological mechanisms and changes in hepatic and splanchnic function leading to the development of haemodynamic changes and portal hypertension in patients with cirrhosis are essential since it guides the search for targets to ameliorate liver-related abnormalities. Recent research has focused on the gut-liver axis, changes in intestinal permeability, translocation of bacterial products, and inflammation as important drivers of haemodynamic alterations and thereby targets for treatment. Additionally, treatment strategies should focus on microbiotic modulation, antiangiogenics, anti-inflammatory strategies, and modulation of bile acid metabolism. This paper aims to review contemporary pathophysiological-based treatment principles of the major complications of cirrhosis and portal hypertension and future targets for treatment.
详细了解和认识导致肝硬化患者血流动力学变化和门静脉高压的肝脏及内脏功能的病理生理机制和变化至关重要，因为这有助于寻找改善肝脏相关异常的靶点。近期研究聚焦于肠 - 肝轴、肠道通透性改变、细菌产物移位及炎症，将其视为血流动力学改变的重要驱动因素，从而作为治疗靶点。此外，治疗策略应侧重于微生物调节、抗血管生成、抗炎策略以及胆汁酸代谢调节。本文旨在综述基于当代病理生理学的肝硬化和门静脉高压主要并发症的治疗原则及未来治疗靶点。
