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低血压、休克和右心衰竭均可引起肝功能不全的临床和实验室表现,异常的肝功能试验可在右心衰竭体征出现以前发生。然而,在缺少低血压或休克的左心衰竭往往并不被认为足引起肝病的原因。作者报告了4例在临床上未出现在心衰竭而在起病时表现象急性或慢性肝炎的患者,其肝活检显示中心性肝坏死而无瘀血或肝炎的证据,经心脏基础病治疗后肝功能均恢复。本组病例的明显肝脏损害,在以往报告中亦见于死于肝静脉流出道阻塞合并症的患者。在狗的实验
Hypotension, shock, and right heart failure can both cause clinical and laboratory manifestations of hepatic insufficiency, and abnormal liver function tests can occur prior to signs of right heart failure. However, left heart failure in the absence of hypotension or shock is often not considered a cause of liver disease. The authors report 4 patients who did not appear clinically to have heart failure but who developed symptoms of acute or chronic hepatitis at onset and whose liver biopsy showed evidence of central hepatic necrosis without blood stasis or hepatitis. Function is restored. Significant liver damage in this group of patients was also seen in previous reports of patients who died of hepatic venous outflow obstruction complications. Experiment in dogs