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心血管疾病引起上消化道出血并非少见,且易被原心血管疾病所掩盖。同时,上消化道出血亦可引起心血管表现或加重原有心血管疾病。因此,正确认识两者之间的相互关系具有重要临床意义。一、引起上消化道出血的心血管疾病1.心源性各种心脏疾病如风湿性心脏病、先天性心脏病、心肌病、心肌炎、心包疾病等的进一步发展而发生右心衰竭时,可致体循环瘀血,静脉压升高,使胃、十二指肠缺血、缺氧,胃粘膜屏障功能减弱,继之发生糜烂出血,尤其在心源性肝硬化时更为多见。左心衰竭引起上消化道出血较右心衰竭少见,且多发生在疾病的晚期。因左心衰竭早期不会引起体循环瘀血,一旦左心衰竭继发右心衰竭,即可引起上
Cardiovascular disease caused by upper gastrointestinal bleeding is not uncommon and easily covered by the original cardiovascular disease. At the same time, upper gastrointestinal bleeding can also cause cardiovascular manifestations or aggravate the original cardiovascular disease. Therefore, a correct understanding of the relationship between the two has important clinical significance. First, caused by upper gastrointestinal bleeding cardiovascular disease 1. Cardiogenic heart disease, such as rheumatic heart disease, congenital heart disease, cardiomyopathy, myocarditis, pericardial disease and the further development of right heart failure occurs when Caused by systemic blood stasis, elevated venous pressure, the stomach, duodenal ischemia, hypoxia, gastric mucosal barrier function weakened, followed by erosion bleeding, especially in patients with cardiogenic cirrhosis more common. Left heart failure caused by upper gastrointestinal bleeding is more rare than right heart failure, and more in the late stages of the disease. Because early left heart failure will not cause systemic blood stasis, once the left heart failure secondary to right heart failure, can cause