Rawson J S, Achord J L
South Med J. 1985 Dec;78(12):1421-5. doi: 10.1097/00007611-198512000-00006.
The clinical syndrome of "shock liver," also known as ischemic hepatitis, is characterized by sudden elevation (to more than 20 times the upper limit of normal) of SGOT and SGPT in response to cellular anoxia, followed by resolution to near normal levels within seven to ten days. In our experience with ten cases, systemic hypotension was documented in only four, but processes characterized by decreased cellular perfusion were identified in all and included cardiac failure or arrhythmia, sepsis, cerebrovascular accidents, renal failure, and chronic obstructive pulmonary disease. We were also able to document the transient rise in serum bilirubin and alkaline phosphatase levels and prolonged prothrombin time that followed the transaminase elevations by 24 to 48 hours in most cases, followed by rapid resolution. In neither of the two cases in which tissue was available by biopsy after resolution of the biochemical abnormalities did we find the classic histologic picture of necrosis in zone 3 ("centrilobular necrosis"). The clinical picture of shock liver is so characteristic and resolves so rapidly that there should be no confusion with other causes of marked elevations of transaminase levels.
“休克肝”的临床综合征，也称为缺血性肝炎，其特征是因细胞缺氧导致谷草转氨酶（SGOT）和谷丙转氨酶（SGPT）突然升高（超过正常上限20倍），随后在7至10天内恢复至接近正常水平。根据我们对10例病例的经验，仅4例记录有全身性低血压，但所有病例均发现存在细胞灌注减少的情况，包括心力衰竭或心律失常、败血症、脑血管意外、肾衰竭和慢性阻塞性肺疾病。我们还记录到，在大多数情况下，转氨酶升高后24至48小时血清胆红素和碱性磷酸酶水平短暂升高，凝血酶原时间延长，随后迅速恢复正常。在生化异常恢复后通过活检获得组织的两例病例中，我们均未发现3区经典的坏死组织学表现（“小叶中心坏死”）。休克肝的临床表现非常典型且恢复迅速，因此不应与转氨酶水平显著升高的其他原因相混淆。
