肝肺综合征和门静脉肺动脉高压

肝脏在维护人体健康和维持机体内环境方面起着重要的作用,患病肝脏将对人体多器官产生有害的作用.包括呼吸系统.终末期肝硬化患者或非肝硬化门脉高压患者会出现呼吸系统功能障碍,包括低氧血症、肺膨胀不全以及肝性胸腔积液等,并通过不同的致病机制影响肺血管系统,即可并发肝肺综合征和(或)门静脉肺动脉高压.肝肺综合征以肺血管扩张为特征,而门静脉肺动脉高压则是以肺内血管阻力增加为特征.肝病晚期患者体内血管活性物质平衡紊乱可能是两者发病机制之一,而决定两者发展的共同因素是门静脉高压,两者是本质不同的并发症,临床表现完全不同,现就两者的各自特点及相互关系作一综述.

Hepatopulmonary syndrome and portopulmonary hypertension

Liver plays a central role in health and homeostasis and thus the diseased liver leads to many harmful effects on multiple organ systems,including pulmonary system. The general effects of cirrhosis on the respiratory system, including mild hypoxemia, atelectasis and hepatic hydrothorax. Cirrhosis is associated with two unique entities that affect the pulmonary vasculature: hepatopulmonary syndrome and (or) portopulmonary hypertension. Hepatopulmonary syndrome is characterized by intrapulmonary vascular dilatations,while portopulmonary hypertension by elevated pulmonary vascular resistance. Pathogenesis of both entities is a putative mechanism,i, e. the imbalance of vasoactive substances in pulmonary vessels. Factor that determines their development must be portal hypertension.