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肝肺综合征和肝肾综合征的临床特征及经颈静脉肝内门体分流术的相关治疗潜力

Clinical characteristics of hepatopulmonary syndrome and hepatorenal syndrome and associated therapeutic potential of transjugular intrahepatic portosystemic shunt.

作者信息

Wang Haoyu, Liu Fuquan

机构信息

Peking University the 9th Clinical Medical College Shijitan Hospital, Beijing 100038, China.

出版信息

ILIVER. 2023 Mar 5;2(1):67-72. doi: 10.1016/j.iliver.2023.02.001. eCollection 2023 Mar.

Abstract

Hepatorenal syndrome (HRS) and hepatopulmonary syndrome (HPS) are two serious complications of liver disease, causing damage not only to the liver but also to the kidneys, lungs, and heart. HRS and HPS affect the patient's circulatory and respiratory systems, with poor prognosis and high mortality in clinical practice. There is a lack of effective treatment other than liver transplantation. Transjugular intrahepatic portosystemic shunt (TIPS) is an effective tool to prolong the survival of patients with advanced liver disease and is mainly used to treat portal hypertension and ascites because it can effectively reduce portal pressure. Studies on the treatment of both of these complications with TIPS are limited and deserve further study because the therapeutic effects of TIPS have the potential to improve the prognosis of severe liver disease. This article reviews the clinical features of HRS and HPS, the consequences of these syndromes, and the potential mechanistic effects after TIPS intervention.

摘要

肝肾综合征(HRS)和肝肺综合征(HPS)是肝病的两种严重并发症,不仅会损害肝脏,还会损害肾脏、肺和心脏。HRS和HPS会影响患者的循环和呼吸系统,临床实践中预后较差且死亡率较高。除肝移植外,缺乏有效的治疗方法。经颈静脉肝内门体分流术(TIPS)是延长晚期肝病患者生存期的有效手段,主要用于治疗门静脉高压和腹水,因为它可以有效降低门静脉压力。关于TIPS治疗这两种并发症的研究有限,值得进一步研究,因为TIPS的治疗效果有可能改善重症肝病的预后。本文综述了HRS和HPS的临床特征、这些综合征的后果以及TIPS干预后的潜在机制效应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e839/12212735/f495c7a31157/gr1.jpg

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