肝硬化心肌病研究进展

Research development of cirrhotic cardiomyopathy

肝硬化患者由于外周阻力下降、动脉压降低、静息心输出量增加，常处于高动力循环状态，致心肌收缩、舒张功能受损，在休息时可无心功能不全表现，但在生理、病理、药理、手术等应激情况下，可出现心功能不全甚至心力衰竭，此种现象称为肝硬化心肌病（Cirrhotic cardiomyopathy，CCM），是肝硬化的并发症之一，近年逐渐受到临床的重视。本文对近年来CCM的发病机制、病理、诊断、治疗等方面的研究进展作一综述。

The expanded blood volume in advanced cirrhosis contributes to a persistent increase in cardiac output, which may overload the heart. In other circumstances, increased cardiac output and augmented cardiac work would cause cardiac failure. But, because of the decreased afterload, as reflected by reduced systemic vascular resistance and increased arterial compliance, left ventrieular failure may be latent in cirrhosis. Cardiac failure may become manifest under strain or treatment with vasoconstrictors. This type of cardiac dysfunction has been termed ＂cirrhotic cardiomyopathy＂ （CCM）. This article reviews current status and research development in the pathogenesis , pathology, diagnosis and therapy of cirrhotic cardiomyopathy.