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目的探讨缺血性肝炎的发病机制,加深对缺血性肝炎的认识。方法回顾性分析26例缺血性肝炎的临床资料,与同期肺源性心脏病和因消化道出血致低血压或休克住院患者临床资料作比较分析。结果 3组患者中缺血性肝炎组和消化道出血组均存有低血压或休克表现,但2组平均动脉压无显著性差异。26例缺血性肝炎中,除有19例患者有下肢水肿、少量腹水或胸水的表现,结合心电图、胸片、彩色多普勒考虑存在右心功能不全;61例因消化道出血致低血压或休克住院患者除消化道出血的临床表现外,无右心功能不全的证据。其中仅有2例肝脏酶学明显升高,而合并诊断缺血性肝炎。结论低血压或休克是引起缺血性肝炎必要条件,但不是唯一条件,右心衰可能对发生缺血性肝炎起一定作用。
Objective To investigate the pathogenesis of ischemic hepatitis and deepen the understanding of ischemic hepatitis. Methods The clinical data of 26 cases of ischemic hepatitis were retrospectively analyzed. The clinical data of patients with pulmonary heart disease and inpatients with hypotension due to gastrointestinal bleeding or shock were compared and analyzed. Results There was hypotension or shock in ischemic hepatitis group and gastrointestinal bleeding group in all three groups, but there was no significant difference in mean arterial pressure between the two groups. Twenty-six patients with ischemic hepatitis had right ventricular dysfunction except for 19 patients with lower extremity edema and a small amount of ascites or pleural effusion. Combined with electrocardiogram, chest radiography and color Doppler, 61 patients had hypotension due to gastrointestinal bleeding Or shock hospitalized patients with gastrointestinal bleeding in addition to the clinical manifestations, no evidence of right heart failure. Only two cases of liver enzymes significantly increased, but the diagnosis of ischemic hepatitis. Conclusion Hypotension or shock is a necessary condition for ischemic hepatitis, but not the only condition. Right heart failure may play a role in the occurrence of ischemic hepatitis.