肝硬化并发多器官功能障碍的发病机制与治疗方案

Research advances in the pathogenesis of multiple organ dysfunction syndrome in patients with liver cirrhosis and related treatment regimens

近年研究表明,肝硬化门静脉高压引起的并发症常累及多个脏器,有学者称之为多器官功能障碍综合征。多器官发生衰竭时,患者短期死亡率明显上升,且死亡率与受累器官数目有关。简述了门静脉高压及内脏血管扩张的病理生理机制,总结了包括心、肺、肾、脑、肝等重要脏器的病理变化及发病机制。肝移植是目前最常用且最有效的治疗手段,但仍存在不足。认为需要进一步研究疾病发展过程中各环节的作用机制,未来可以发现更多靶点来预防及治疗肝硬化患者多器官功能障碍。

Recent studies have shown that complications of cirrhotic portal hypertension often involve multiple organs,which is called multiple organ dysfunction syndrome by some scholars. When multiple organ failure occurs,there is a significant increase in patients＇ short-term death rate,and death rate is associated with the number of organs involved. This article briefly describes the physiopathologic mechanisms of portal hypertension and visceral vasodilation and summarizes the pathological changes of vital organs including the heart,lung,kidney,brain,and liver and related pathogenesis. At present,liver transplantation remains the most effective therapy,but it still has some shortcomings. It is pointed out that further studies are needed to investigate the mechanisms of action of each link in disease development,and more targets are needed in the future to prevent and treat multiple organ dysfunction syndrome in patients with liver cirrhosis.