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World Journal of Gastroenterology 2021年第42期27卷 7299-7310页

作者： Sinan Sadalla Andrea Lisotti Lorenzo Fuccio Pietro Fusaroli UnitàOperativa Complessa di gastroenterologia e Endoscopia digestiva Universitàdi Bologna/Ospedale di ImolaImola(BO)40024Italy UnitàOperativa Complessa di gastroenterologia e Endoscopia digestiva Universitàdi Bologna/Ospedale di ImolaImola(BO)40026Italy divisione di gastroenterologia Dipartimento di Scienze Medico-Chirurgiche(DIMEC)IRCSS-Azienda Ospedaliero-Universitaria di BolognaBologna 40138Italy

Colonoscopy is a risk factor for colon ischemia.The colon is susceptible to ischemia due to its minor blood flow compared to other abdominal organs;the etiology of colon ischemia after colonoscopy is multifactorial.The causative mechanisms include splanchnic circulation impairment,bowel preparation,drugs used for sedation,bowel wall ischemia due to insufflation/barotrauma,and introduction of the endoscope.Gastroenterologists must be aware of this condition and its risk factors for risk minimization,early diagnosis,and proper treatment.

关键词： Endoscopy Colon ischemia Colonoscopy Bowel preparation Mesenteric circulation Ischemic colitis

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失代偿性肝硬化患者管-球反馈丧失的病理生理学意义

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世界核心医学期刊文摘（胃肠病学分册） 2005年第9期1卷 11-11页

作者： Sansoè G. Silvano S. Mengozzi G. 王志宇 divisione di gastroenterologia Ospedale Gradenigo C.so Regina Margherita 10 10 153 Torino Italy Dr.

In healthy subjects, arterial pressure reduction or renal ischemia produces renal artery dilatation through autoregulation and tubuloglomerular feedback (TuGF). Patients with decompensated cirrhosis have reduced kidney perfusion pressure but show renal vasoconstriction instead of autoregulation-mediated vasodilation. This study investigates the consequences of kidney autoregulation loss on renal perfusion, glomerular filtration rate, and tubular handling of electrolytes in both compensated and ascitic nonazotemic cirrhotic patients. Forty-two consecutive patients with diuretic-free liver cirrhosis (32 with preascitic and 10 with ascitic disease) and 10 controls were submitted to the following determinations: (a) basal plasma renin activity and aldosterone levels; (b) endogenous dopaminergic activity measured as incremental aldosterone responses during metoclopramide administration; and (c) renal clearances of sodium, potassium, inulin, para-aminohippurate and lithium. Compared with the other groups, ascitic patients showed lower renal plasma flow (P displayed tubuloglomerular feedback (the mechanism increasing the glomerular filtration rate when a reduced sodium load reaches the distal tubule), as demonstrated by negative correlations between fractional excretion of lithium (an expression of fractional delivery of sodium to the distal nephron) and glomerular filtration rate (respectively, r = -0.73, P dicative of prevalent postglomerular arteriolar vasoconstriction, with ensuing stimulation of proximal tubular sodium reabsorption.

关键词：失代偿性肝硬化病理生理学腹水患者醛固酮水平血浆肾素活性肾小球滤过率滤过分数排泄率肾动脉清除率

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