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中华医学超声杂志(电子版) ›› 2022, Vol. 19 ›› Issue (06) : 499 -503. doi: 10.3877/cma.j.issn.1672-6448.2022.06.002

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现代影像学诊断肝肺综合征的研究进展
张红梅1, 尹立雪1,()   
  1. 1. 610072 成都,电子科技大学附属医院·四川省人民医院心血管超声及心功能科 超声心脏电生理学与生物力学四川省重点实验室 四川省心血管病临床医学研究中心 国家心血管疾病临床医学研究中心分中心
  • 收稿日期:2022-04-19 出版日期:2022-06-01
  • 通信作者: 尹立雪
  • 基金资助:
    四川省科技厅重点研发项目(2021YFS0379)

Advances in diagnosis of hepatopulmonary syndrome by modern imaging

Hongmei Zhang1, Lixue Yi1()   

  • Received:2022-04-19 Published:2022-06-01
  • Corresponding author: Lixue Yi
引用本文:

张红梅, 尹立雪. 现代影像学诊断肝肺综合征的研究进展[J]. 中华医学超声杂志(电子版), 2022, 19(06): 499-503.

Hongmei Zhang, Lixue Yi. Advances in diagnosis of hepatopulmonary syndrome by modern imaging[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2022, 19(06): 499-503.

肝肺综合征(hepatopulmonary syndrome,HPS)指当肝脏疾病发展到一定阶段,伴随而来的肺血管扩张、肺气体交换障碍及动脉血氧分压(pressure of oxygen,PaO2)下降。HPS是终末期肝病常见的肺部并发症,其特征是肺血管扩张导致动脉氧合功能受损,以致动脉血氧合障碍。其诊断标准为:(1)肝脏疾病史;(2)肺内血管扩张(intrapulmonary vascular dilatations,IPVD);(3)肺泡-动脉氧分压差≥15 mmHg(1 mmHg=0.133 kPa),如果年龄≥65岁,则肺泡-动脉氧分压差>20 mmHg。HPS是终末期肝病的并发症之一,严重影响患者预后。近年来文献报道HPS在终末期肝病患者中的发病率约为40%123。HPS早期发病隐匿,症状易被其他病症掩盖,临床误诊率较高,预后较差。肝移植是目前晚期HPS唯一有效的治疗手段。因此,HPS的早期诊断和早期治疗是改善患者预后的关键4。肝病患者合并存在肺动脉氧合降低时,则应考虑HPS,但病患仅存在血氧饱和度异常尚不足以诊断HPS1。近来,HPS诊断的影像学研究日益引起关注,本文对HPS的各种影像学诊断方法及相关进展作一评述,以期为临床提供参考。
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