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目的:探讨急性心源性肝损害的临床特征、诊治经验及预后。方法:收集急性心脏疾病并心源性肝损害的患者24例,记录其临床资料及肝功能演变过程,分析其病因、临床特征及预后。14例不伴明显肝损害的急性心脏病患者作为对照组。结果:急性心源性肝损害发病基础病因各异,并非只发生于肝脏缺血患者;急性心源性肝损害患者肝功能损害突出,经原发病治疗后多数迅速好转,1周后丙氨酸氨基转移酶(ALT)由高峰期(2 981±979)U/L降为(659±870)U/L,AST由高峰期(2 743±967)U/L降为(706±830)U/L,少数肝功能恶化,其中2例死于肝衰竭。结论:急性心源性肝损害临床上需要更多重视,其病因及机制与多种因素有关,临床转归多数良好,少数恶化。
Objective: To investigate the clinical features, diagnosis and treatment experience and prognosis of acute cardiogenic liver damage. Methods: Twenty-four patients with acute heart disease and cardiogenic liver injury were collected. The clinical data and the evolution of liver function were recorded. The etiology, clinical features and prognosis were analyzed. Fourteen patients with acute heart disease who did not have significant liver damage served as controls. Results: The causes of acute cardioembolic liver injury were different according to different causes, not only occurred in patients with hepatic ischemia. In patients with acute cardiogenic liver injury, hepatic dysfunction was prominent. Most of the patients were treated with primary disease, The ALT decreased from peak (2 981 ± 979) U / L to (659 ± 870) U / L, and peak AST decreased from (2 743 ± 967) U / L to (706 ± 830) U / L, a small number of liver dysfunction, of which 2 died of liver failure. CONCLUSION: Acute cardioembolic liver injury needs more attention in clinic. The etiology and mechanism are related to many factors. Most of the clinical outcomes are good and few are worsen.