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为完成代谢功能,肝脏需要血液供给,即使面临严重的血液动力学失调也能维持血液供给,在多数情况下,门静脉和肝动脉的双重血液供给提供这种保护作用。偶尔,甚至这种机制也不能使肝脏免受急性循环损伤的影响,其结果是一般称作的“缺血性肝炎”,因为肝脏伴有类似急性肝炎的生化改变。具有特征性的组织学改变,即肝中央小叶坏死,完全不同于急性病毒性或药物性肝炎的组织学改变,但是这些病人的血液动力学状态经常妨碍肝活检。澳大利亚的一篇综述引起了对此病临床特征的注意并提供了有用的、非创伤性诊断标准。
To perform metabolic functions, the liver needs blood to maintain its blood supply even in the face of severe hemodynamic disturbances. In most cases, the dual blood supply of portal and hepatic arteries provides this protection. Occasionally, even this mechanism does not protect the liver from acute circulation damage, the result of which is commonly referred to as “ischemic hepatitis,” as the liver is accompanied by biochemical changes like acute hepatitis. A characteristic histological change, namely, central leaflet necrosis of the liver, is completely different from the histological changes of acute viral or drug-induced hepatitis, but the hemodynamic status of these patients often hinder liver biopsy. A review in Australia raises awareness of the clinical features of the disease and provides useful, non-invasive diagnostic criteria.