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缺血性肝炎是可逆性严重低血压或心衰的常见并发症,预后通常取决于导致低血压和心衰的病因而不是肝功能损害的程度。诊断根据:1.严重低血压发生后36小时内有持续而显著的血清转氨酶升高;2.缺乏急、慢性甲、乙型肝炎病毒感染的血清标志物;3.排除近期急性心肌梗塞;4.排除对毒素和化学物暴露的诊断标准,作者仔细分析过去20月间确诊的9例缺血性肝炎病人发现,大多数病人正在服用多种药物,而且从临床上排除了药物诱发的肝脏损害。9例病人分别患周围血管疾病、肺炎、蜂窝织炎、脱水、败血症、心衰等心源性或低血容量性休克。实验室资料显示发病的1～3天内血清AST和LDH迅速升高,达正常的60～200倍。然后8例病人在疾病的第8天内又同样迅速下降到正常。这9例病人均无高血糖往史,其中5例在病后48小时内、1例在14天见血糖升高,达13.6～48.4
Ischemic hepatitis is a common complication of reversible severe hypotension or heart failure, and the prognosis often depends on the extent of the cause of hypotension and heart failure rather than the impairment of liver function. The diagnosis is based on: 1. A sustained and significant increase in serum aminotransferases within 36 hours of severe hypotension; 2. Serological markers of acute and chronic hepatitis A and B virus infections; 3. Exclusion of recent acute myocardial infarction; 4 Excluding diagnostic criteria for toxins and chemical exposures, the authors scrutinize 9 confirmed cases of ischemic hepatitis in the past 20 months and found that most patients were taking multiple medications and clinically excluded drug-induced liver damage . 9 patients were suffering from peripheral vascular disease, pneumonia, cellulitis, dehydration, sepsis, heart failure and other cardiogenic or hypovolemic shock. Laboratory data show that the onset of 1 to 3 days serum AST and LDH rapidly increased, up to 60 to 200 times the normal. Eight patients then similarly dropped rapidly to normal within the eighth day of the disease. None of the 9 patients had any history of hyperglycemia, with 5 of the 5 patients having a rise in blood glucose of 13.6 to 48.4 within 48 hours after the illness and one having a 14-day disease