胆汁酸在肝硬化心肌病中的作用

Role of bile acids in cirrhosis-related cardiomyopathy

肝硬化心肌病(CCM)是肝硬化伴有的一种常见且容易被忽视的并发症,其发病率较高,且对肝移植和经颈静脉肝内门体分流术的预后有明显影响,近年来引起研究人员的高度关注。肝硬化患者常伴有血清总胆汁酸水平升高和胆汁酸组成改变,而高浓度胆汁酸具有心脏毒性。基于文献证据,本文总结了肝硬化患者胆汁酸代谢的改变、胆汁酸对心脏功能的影响及熊去氧胆酸为CCM的潜在治疗药物3个方面内容,旨在为CCM的预防和治疗提供新思路。

Liver cirrhosis-related cardiomyopathy(CCM) is a common and easily overlooked complication associated with liver cirrhosis.Because of the high incidence and impact on success of the liver transplantation and the transcarotid intrahepatic portosystemic shunt surgery,it has attracted the attention of researchers in the field recently.Liver cirrhosis patients have liver morphological alterations,which result in increased serum level of total bile acids and changes in bile acid composition.The increased bile acid concentrations are cardiotoxic and change cardiac functions.This study discussed and summarized recent advancements in the role of bile acids in cirrhosis-related cardiomyopathy in three aspects,i.e.,changes in bile acid metabolism in liver cirrhosis patients,effects of bile acid on changes in cardiac functions,and ursodeoxycholic acid as a potential therapeutic agent for CCM.This review expects to provide novel approaches for future prevention and treatment of CCM.