Occurrence and progression of hemodynamic dysfunction in cirrhotic portal hypertension
10.3760/cma.j.cn115610-20210813-00394
- VernacularTitle:肝硬化门静脉高压血流动力学紊乱发生及发展机制
- Author:
Deng HUANG
1
;
Jungui CAO
;
Hangyang YE
;
Yun WANG
;
Jianwei ZHENG
Author Information
1. 中国人民解放军西藏军区总医院肝胆科，拉萨 850007
- Keywords:
Liver cirrhosis;
Portal hypertension;
Hepatic sinusoid;
Hemodynamics;
Hyperdynamic circulation
- From:
Chinese Journal of Digestive Surgery
2021;20(10):1117-1122
- CountryChina
- Language:Chinese
-
Abstract:
Cirrhotic portal hypertension refers to a series of syndroms characterized by structural abnormality and dysfunction of hepatic sinusoid caused by chronic liver injury and obstructing portal-systemic blood flow, resulting in gradually increased portal venous system pressure as clinical manifestations. Increased intrahepatic resistance and portal venous system blood flow are main causes for cirrhotic portal hypertension. The structural abnormality and dysfunction of hepatic sinusoid cause not only increased intrahepatic resistance, but also substance exchange barriers between hepatic sinusoidal blood and hepatocytes, resulting in splanchnic artery dilation and increased blood flow and pressure of portal venous system. Dysfunction of splanchnic hemodynamic is an important factor for hyperdynamic circulation in cirrhotic portal hypertension. As the disease progresses, cirrhotic portal hypertension can continuously promote the activation of hyperdynamic circulation, which in turn can accelerate the development of cirrhotic portal hyperten-sion. This vicious circle is the main reason for the irreversible and untreatable end-stage liver disease. The authors review the pathophysiological mechanisms of cirrhotic portal hypertension, splanchnic hemodynamic dysfunction and hyperdynamic circulation.
