Hill D M, Warren S E, Mitas J A, Swerdlin A H
South Med J. 1980 Jul;73(7):906-8, 911. doi: 10.1097/00007611-198007000-00023.
Fulminant hepatic failure has been reported in patients with chronic congestive heart failure. Two patients in whom jaundice and coma followed cardiac surgery were studied to find the possible etiology. Clinical, biochemical, and histologic evaluations revealed low cardiac output; elevated levels of bilirubin, lactic dehydrogenase, serum glutamic oxaloacetic transaminase, and alkaline phosphatase; prolonged prothrombin time; and centrizonal necrosis of hepatocytes with sinusoidal dilatation. No other possible causes of hapatic dysfunction and coma were identified. We conclude that acute postoperative congestive heart failure may cause fulminant hepatic failure and metabolic encephalopathy.
据报道，慢性充血性心力衰竭患者可发生暴发性肝衰竭。对两名心脏手术后出现黄疸和昏迷的患者进行了研究，以寻找可能的病因。临床、生化和组织学评估显示心输出量降低；胆红素、乳酸脱氢酶、血清谷草转氨酶和碱性磷酸酶水平升高；凝血酶原时间延长；肝细胞中央带坏死伴肝血窦扩张。未发现肝功能障碍和昏迷的其他可能原因。我们得出结论，急性术后充血性心力衰竭可能导致暴发性肝衰竭和代谢性脑病。
