Hypoxic hepatitis, also known as ischemic hepatitis, is characterized by acute hepatocellular injury due to inadequate oxygen delivery to the liver. Celiac trunk stenosis can lead to hepatic ischemia and subsequent li...Hypoxic hepatitis, also known as ischemic hepatitis, is characterized by acute hepatocellular injury due to inadequate oxygen delivery to the liver. Celiac trunk stenosis can lead to hepatic ischemia and subsequent liver damage. We present the case of an 81-year-old patient with a history of hypertension, ischemic heart disease, hypothyroidism, and biliary lithiasis, who developed hypoxic hepatitis secondary to Dunbar syndrome and a stenosis of the superior mesenteric artery. The patient improved symptoms and liver function tests with conservative management, including intravenous fluids and supportive care. Long-term management involved continued antiplatelet therapy and statins, with consideration of further interventions for celiac trunk stenosis. This case underscores the importance of recognizing Dunbar syndrome as well as superior mesentery trunk stenosis as a potential cause of hypoxic hepatitis. It highlights the need for multidisciplinary management in such cases.展开更多
目的探讨肝硬化食管胃底静脉曲张破裂出血(esophageal and gastric varices bleeding,EGVB)继发缺血性肝炎的相关危险因素。方法回顾性分析2020年1月至8月沈阳市第六人民医院102例EGVB患者的临床资料,根据是否出现缺血性肝炎分为观察组...目的探讨肝硬化食管胃底静脉曲张破裂出血(esophageal and gastric varices bleeding,EGVB)继发缺血性肝炎的相关危险因素。方法回顾性分析2020年1月至8月沈阳市第六人民医院102例EGVB患者的临床资料,根据是否出现缺血性肝炎分为观察组和对照组。对一般资料、实验室指标、辅助检查结果、临床情况进行单因素分析,二元Logistic多因素分析EGVB后继发缺血性肝炎的相关危险因素。结果102例EGVB患者中,14例伴有缺血性肝炎(转氨酶升高>10倍正常值上限)纳入观察组,余88例纳入对照组。观察组死亡5例,是对照组的4.46倍。观察组ALT、AST峰值多出现在入院第2日,依次为791.00(555.25,1657.5)U/L、2541.50(1480.50,4594.00)U/L。单因素分析结果显示,观察组和对照组ALT、AST、γ-GGT、LDH、TBil、白细胞、血小板计数、脾长、脾门静脉、门脉主干内径、门静脉血栓、死亡、合并肝性脑病、合并脓毒症、Child-Pugh评分、腹腔积液等指标,差异有统计学意义(均P<0.05);二元logistic多因素分析显示,伴有肝癌(P<0.01)、白细胞计数(P=0.014)、γ-GGT(P=0.025)、Child-Pugh分级(P=0.050)与EGVB后出现缺血性肝损伤具有显著相关性。结论伴有肝癌、白细胞计数、肝硬化Child-Pugh分级是EGVB合并缺血性肝炎的危险因素。展开更多
Objective To establish and evaluate an animal model with hypoxic hepatitis.Methods 100 male Sprague-Dawley rats were randomised into two groups.70 rats received isoproterenol(5mg /kg /day)intraperitoneally and the rem...Objective To establish and evaluate an animal model with hypoxic hepatitis.Methods 100 male Sprague-Dawley rats were randomised into two groups.70 rats received isoproterenol(5mg /kg /day)intraperitoneally and the remaining 30 were used as control and received placebo(0.05% ascorbic acid in 0.9% NaCl)on a daily basis for 7 days.Liver function tests were carried out to demonstrate the establishment of hypoxic hepatitis.Brain-natriuretic pep-tide(BNP)was investigated to diagnose heart failure.Histopathological examination of the heart and liver were performed.Results Overall mortality rate following 7 days of isoproterenol injection was 5%.Raised BNP level(130 + 6 pg /ml)confirmed the development of heart failure while after 14 days the abnormally raised liver function tests(ALT:840 + 4U /L,AST:1818 + 2U /L,ALK.Phos:484 + 4U /L,LDH:922 + 2U /L)indicated the establishment of HH.Histopathological exams revealed that the atria and ventricles were significantly hypertrophied and fibrosis was observed in the ventricles.The specimen of the liver showed centrilobular necrosis and apoptosis of the hepatocytes.Conclusion These results suggest that inducing heart failure in rats is a favorable approach and is technically feasible in terms of establishment of hypoxic hepatitis in an animal model.展开更多
文摘Hypoxic hepatitis, also known as ischemic hepatitis, is characterized by acute hepatocellular injury due to inadequate oxygen delivery to the liver. Celiac trunk stenosis can lead to hepatic ischemia and subsequent liver damage. We present the case of an 81-year-old patient with a history of hypertension, ischemic heart disease, hypothyroidism, and biliary lithiasis, who developed hypoxic hepatitis secondary to Dunbar syndrome and a stenosis of the superior mesenteric artery. The patient improved symptoms and liver function tests with conservative management, including intravenous fluids and supportive care. Long-term management involved continued antiplatelet therapy and statins, with consideration of further interventions for celiac trunk stenosis. This case underscores the importance of recognizing Dunbar syndrome as well as superior mesentery trunk stenosis as a potential cause of hypoxic hepatitis. It highlights the need for multidisciplinary management in such cases.
文摘目的探讨肝硬化食管胃底静脉曲张破裂出血(esophageal and gastric varices bleeding,EGVB)继发缺血性肝炎的相关危险因素。方法回顾性分析2020年1月至8月沈阳市第六人民医院102例EGVB患者的临床资料,根据是否出现缺血性肝炎分为观察组和对照组。对一般资料、实验室指标、辅助检查结果、临床情况进行单因素分析,二元Logistic多因素分析EGVB后继发缺血性肝炎的相关危险因素。结果102例EGVB患者中,14例伴有缺血性肝炎(转氨酶升高>10倍正常值上限)纳入观察组,余88例纳入对照组。观察组死亡5例,是对照组的4.46倍。观察组ALT、AST峰值多出现在入院第2日,依次为791.00(555.25,1657.5)U/L、2541.50(1480.50,4594.00)U/L。单因素分析结果显示,观察组和对照组ALT、AST、γ-GGT、LDH、TBil、白细胞、血小板计数、脾长、脾门静脉、门脉主干内径、门静脉血栓、死亡、合并肝性脑病、合并脓毒症、Child-Pugh评分、腹腔积液等指标,差异有统计学意义(均P<0.05);二元logistic多因素分析显示,伴有肝癌(P<0.01)、白细胞计数(P=0.014)、γ-GGT(P=0.025)、Child-Pugh分级(P=0.050)与EGVB后出现缺血性肝损伤具有显著相关性。结论伴有肝癌、白细胞计数、肝硬化Child-Pugh分级是EGVB合并缺血性肝炎的危险因素。
文摘Objective To establish and evaluate an animal model with hypoxic hepatitis.Methods 100 male Sprague-Dawley rats were randomised into two groups.70 rats received isoproterenol(5mg /kg /day)intraperitoneally and the remaining 30 were used as control and received placebo(0.05% ascorbic acid in 0.9% NaCl)on a daily basis for 7 days.Liver function tests were carried out to demonstrate the establishment of hypoxic hepatitis.Brain-natriuretic pep-tide(BNP)was investigated to diagnose heart failure.Histopathological examination of the heart and liver were performed.Results Overall mortality rate following 7 days of isoproterenol injection was 5%.Raised BNP level(130 + 6 pg /ml)confirmed the development of heart failure while after 14 days the abnormally raised liver function tests(ALT:840 + 4U /L,AST:1818 + 2U /L,ALK.Phos:484 + 4U /L,LDH:922 + 2U /L)indicated the establishment of HH.Histopathological exams revealed that the atria and ventricles were significantly hypertrophied and fibrosis was observed in the ventricles.The specimen of the liver showed centrilobular necrosis and apoptosis of the hepatocytes.Conclusion These results suggest that inducing heart failure in rats is a favorable approach and is technically feasible in terms of establishment of hypoxic hepatitis in an animal model.
