摘要: |
肝肺综合征(hepato-pulmonary syndrome,HPS)是在慢性肝病和(或)门脉高压的基础上出现肺内血管异常扩张、气体交换障碍、动脉血氧合作用异常,导致低氧血症及一系列的病理生理变化和临床表现,是终末期肝脏病的严重肺部并发症。动物实验表明肺微血管扩张、血管新生和血管内单核巨噬细胞聚集是导致气体交换异常的主要原因,但具体机制仍不明确。目前HPS尚缺乏有效的治疗药物,肝移植仍是最有效的治疗方法。本研究将重点讨论HPS的发病机制和临床诊治相关的新进展。 |
关键词: 肝肺综合征 肺内血管扩张 慢性肝病 门静脉高压 |
DOI:10.12025/j.issn.1008-6358.2018.20170692 |
分类号:R 575.2 |
基金项目:国家自然科学基金(81500457,81670541),科技部支撑计划课题(2015BAI13B09),科技部病毒性肝炎重大专项子课题(2013ZX10002004-002). |
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Research progress on hepato-pulmonary syndrome |
CHEN Wei-wen, WU Sheng-di*, JIANG Wei
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Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
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Abstract: |
Hepato-pulmonary syndrome (HPS) is a severe pulmonary complication of the end-stage liver disease,based on chronic liver disease and/or portal hypertension, pulmonary vascular dilatation, gas exchange disorder, and arterial oxygenation abnormality occur, resulting in hypoxemia and a series of pathophysiological changes and clinical manifestations.Animal experiments have revealed that pulmonary microvascular dilatation, angiogenesis, and accumulation of intravascular mononuclear macrophages were the main causes of gas exchange abnormality, but the specific mechanism is still unclear. HPS is lack of effective drug treatment, and liver transplantation is the only effective therapy. In this review, we focus on the recent advances in pathogenesis, clinical diagnosis and treatment of HPS. |
Key words: hepato-pulmonary syndrome pulmonary arterial hypertension portal hypertension intrapulmonary vascular dilatation |