JACC:先天性心脏病患者的蛋白丢失肠病病因研究

2017-06-20 MedSci MedSci原创

蛋白丢失肠病(PLE),其特点是在肠内失去蛋白质,是先天性心脏病患者的一种毁灭性的并发症。PLE的病因尚不清楚,但怀疑与淋巴管有关。

背景:蛋白丢失肠病(PLE),其特点是在肠内失去蛋白质,是先天性心脏病患者的一种毁灭性的并发症。PLE的病因尚不清楚,但怀疑与淋巴管有关。

目的:对淋巴管造影和肝淋巴栓塞应用于治疗PLE进行了评价。

方法:采用单中心、回顾性研究方法,对8例肝淋巴栓塞和先天性心脏病的患者进行影像学和干预治疗,其中并发有较高的中央静脉压力。

结果:肝淋巴管造影在8例患者(5名男性,3名女性,平均年龄:21岁)中进行,其中7例通过异常的肝十二指肠淋巴通信显示肝淋巴漏入十二指肠。经十二指肠镜检查,同时向肝淋巴管内注射异硫蓝染剂,7例患者中有6例被应验。2例患者肝淋巴管栓塞,导致白蛋白血水平暂时增加,1例患者的症状改善,但两例患者均并发十二指肠出血。在剩下的6名患者中,肝淋巴栓塞与n-正丁基氰基丙烯酸酯的结合导致了3例患者血清白蛋白水平和症状的持续改善,2例患者的暂时改善,1例患者没有改善,随访中值时间为135天(范围为84至1005天)。

结论:肝淋巴渗漏是造成先天性心脏病并发中央静脉高压的原因之一。淋巴栓塞导致了白蛋白水平的改善和症状的减轻。需要进一步的研究来确定这一过程的长期结果。

原始出处:
Maxim Itkin,David A.Piccoli,Gregory Nadolski,et al. Protein-Losing Enteropathy in Patients With Congenital Heart Disease. JACC. 2017 June.

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    2018-04-15 hbwxf
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    2017-06-21 huirong
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    2017-06-21 ylzr123

    认真学习,把间接经验应用到临床实践中去,然后再总结出新思路。给点赞啦

    0

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