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脾动脉盗血综合征:一个被忽视的肝病治疗靶点

刘全达 宋扬 周宁新

引用本文:
Citation:

脾动脉盗血综合征:一个被忽视的肝病治疗靶点

基金项目: 

北京市首都临床特色应用研究重点项目(D101100050010042); 中国博士后科学基金(20080441275); 

详细信息
  • 中图分类号: R657.3

Splenic arterial steal syndrome:a neglected therapeutic target for liver diseases

Research funding: 

 

  • 摘要: 肝脏对动脉低灌注所致的缺氧非常敏感,这在肝移植术后移植物并发症(如肝动脉血栓形成、动脉瘤)中已经得到证实,可导致严重的胆道缺血性损害、移植物失功能、甚至受体死亡等严重并发症。脾动脉盗血综合征(SASS)是肝移植术后一种较少认识的动脉并发症。SASS本质是粗大的脾动脉"盗走"肝动脉血流而导致肝动脉灌注不良;不及时干预,SASS亦可导致严重的移植物并发症。目前临床上尚未形成"肝硬化性SASS"概念,更未认识其危害性。肝硬化性SASS是慢性肝病损害的结果,并加重肝损害的病理过程,临床上无特异性,多表现为基础肝病合并脾脏肿大等异常。我们通过三维CT血管成像及血管造影证实失代偿期肝硬化患者普遍存在SASS,并证实纠正SASS后肝硬化患者的肝功能指标、Child-Pugh评分、评级等显著改善,并降低了消化道出血风险。因此,该文在国际上首次提出了肝硬化性SASS概念,并证实SASS是失代偿期肝硬化患者改善肝功能的一个有效治疗靶点,可作为等待肝移植的架桥性治疗措施。

     

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  • 出版日期:  2011-03-20
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