Advances in Research on the Effects of Liver Cirrhosis on Cardiovascular System and Related Mechanisms
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摘要: 肝硬化全球发病率高，危害严重。诸多研究表明，肝硬化可能引起患者心血管异常，而后者又与病情的严重程度密切相关，并可能对肝硬化患者的预后造成不良影响。因此，对高动力循环、门脉高压性肺动脉高压、心脏收缩和舒张功能障碍、心电生理异常以及肝硬化心肌病等方面的发病机制及研究新进展进行综述。为进一步深入研究肝硬化的防治策略奠定基础。Abstract: Cirrhosis has a high global incidence rate and serious harm. Numerous studies have shown that liver cirrhosis may cause cardiovascular abnormalities in patients, which are closely related to the severity of the condition and may have adverse effects on the prognosis of liver cirrhosis patients. Therefore, the pathogenesis and research progress in hyperdynamic circulation, portal hypertension pulmonary hypertension, cardiac systolic and diastolic dysfunction, cardiac electrophysiologic abnormalities, and cirrhotic cardiomyopathy are reviewed. To lay the foundation for further in-depth research on the prevention and treatment strategies of liver cirrhosis.
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Key words:
- Cirrhosis /
- Cardiovascular system /
- Portal Hypertension /
- Mechanism
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表 1 CCM的定义[46]
Table 1. Definition of CCM
2005年 2019年 收缩功能障碍
（任意一种情况）收缩功能障碍
（任意一种情况）对压力测试的钝性收缩反应 左心室射血分数≤50% 左心室射血分数<55% 绝对GLS<18%或>22% 舒张功能障碍
（任意一种情况）舒张功能障碍
（任意一种情况）减速时间>200 ms 间隔e’<7 cm/s 等容松弛时间>80 ms E/e'比值≥15 E/A<1 LAVI>34 mL/m2 支持标准 TR>2.8 m/s 机电异常 进一步验证 对压力的反应时性反应异常 变时性或正性肌力反应异常 机电解耦 心电图改变 QTc间期延长 机电解耦 左心房扩大 心肌质量变化 左心质量增加 血清生物标志物 BNP前体和BNP增加 腔室扩大 肌钙蛋白1增加 CMRI的ECV 
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