المتلازمة القلبية الكبدية بين مرضى قصور القلب في صنعاء اليمن

المؤلفون

  • ﺩ/ ﺷﻮﻗﻲ ﺣﺴﻴﻦ ﻧﺎﺟﻲ ﺍﻟﻌﻮﺩﻱ جامعة 21 سبتمبر للعلوم الطبية والتطبيقية المؤلف
  • احمد ابراهيم الخولي جامعة 21 سبتمبر للعلوم الطبية والتطبيقية المؤلف
  • ﺍﺻﻴﻞ ﻋﺒﺪﺍﻟﺠﺒﺎﺭ ﺭﻳﺸﺎﻥ جامعة 21 سبتمبر للعلوم الطبية والتطبيقية المؤلف
  • ﺇﺑﺮﺍﻫﻴﻢ ﻋﺒﺪﷲ ﺑﺎﻛﺮ جامعة 21 سبتمبر للعلوم الطبية والتطبيقية المؤلف
  • ﺍﺻﻴﻞ ﻋﺒﺪﺍﻟﺤﻠﻴﻢ ﺧﺎﻭﺯ جامعة 21 سبتمبر للعلوم الطبية والتطبيقية المؤلف
  • ﺍﺳﺎﻣﻪ ﺣﺴﻦ ﺍﻟﻘﻌﻴﺶ جامعة 21 سبتمبر للعلوم الطبية والتطبيقية المؤلف
  • ﺍﺻﺎﻟﺔ ﻋﺒﺪﺍﻟﺤﻠﻴﻢ ﺧﺎﻭﺯ جامعة 21 سبتمبر للعلوم الطبية والتطبيقية المؤلف
  • ﻏﺎﺩﺓ ﻋﺎﺩﻝ ﺑﺎﺩﻱ المؤلف
  • ﺳﺎﺭﺓ ﻋﺒﺪﺍﻟﻌﺰﻳﺰ ﺍﻟﺒﻜﻴﺮ جامعة 21 سبتمبر للعلوم الطبية والتطبيقية المؤلف
  • ﻋﺒﻴﺮ ﻣﺤﻤﺪ ﻣﻬﺪﻱ جامعة 21 سبتمبر للعلوم الطبية والتطبيقية المؤلف
  • ﻟﻤﻴﺎﺀ ﻣﺤﻤﻮﺩ ﻣﺪﻫﻴﺶ جامعة 21 سبتمبر للعلوم الطبية والتطبيقية المؤلف
  • ﻃﺎﺭﻕ ﻋﻠﻲ ﺍﻟﺴﻴﺎﻏﻲ جامعة 21 سبتمبر للعلوم الطبية والتطبيقية المؤلف
  • ﻫﻴﺜﻢ ﺣﺎﻣﺲ ﻗﺎﺳﻢ جامعة 21 سبتمبر للعلوم الطبية والتطبيقية المؤلف
  • ﻧﻮﺭ ﻋﻠﻲ ﺍﻟﻌﺰﻋﺰﻱ جامعة 21 سبتمبر للعلوم الطبية والتطبيقية المؤلف

DOI:

https://doi.org/10.65693/irss.2022.v3i1.305

الكلمات المفتاحية:

المتلازمة القلبية الكبديةإزالة المتلازمة القلبية الكبدية دراسة مقطعية صنعاء اليمن

الملخص

متلازمة القلب والكبد بين مرضى قصور القلب في اليمن

الذين راجعوا عدة مستشفيات خاصة وحكومية في مدينة صنعاء، اليمن.   منهجية الدراسة: أُجريت دراسة مقطعية سريرية على مرضى قصور القلب الذين تم إدخالهم إلى الأقسام الطبية في عدة مستشفيات خاصة وعامة في مدينة صنعاء خلال الفترة من 1 يوليو 2021 إلى 31 ديسمبر 2021.   النتائج: شملت الدراسة ما مجموعه 162 حالة مُشخصة بمتلازمة القلب والكبد. كان عدد المرضى الذكور 117 مريضاً (72.2%) والإناث 45 مريضة (27.8%). تراوحت أعمار المرضى بين 0.5 و81 عاماً، وأظهرت النتائج أن غالبية المرضى (66.1%) تتراوح أعمارهم بين 41 و70 عاماً. تم إدخال معظم المرضى إلى مستشفى لبنان (75.3%)، تلاه مستشفى الثورة (10.5%). كانت العلامات السريرية الأكثر شيوعاً لدى المرضى هي: الوذمة (56.2%)، والشحوب (40.7%)، والزراق (25.3%). بينما كانت العلامات الأقل شيوعاً هي اليرقان (8.6%) وتعجر الأصابع (8%). بلغ متوسط معدل النبض 94 نبضة/دقيقة (بحد أقصى 142 وأدنى حد 37)، ومتوسط ضغط الدم الانقباضي 118 ملم زئبق (بحد أقصى 200 وأدنى حد 60)، ومتوسط ضغط الدم الانبساطي 75 ملم زئبق (بحد أقصى 120 وأدنى حد 40). شملت الفحوصات المخبرية لتقييم وظائف الكبد: البيليروبين الكلي، والمباشر، وغير المباشر، وإنزيمات الكبد (AST, ALT, ALP)، والبروتين الكلي، والألبومين، وزمن البروثرومبين، وزمن الثرومبوبلاستين الجزئي المنشط. بالإضافة إلى ذلك، أُجريت فحوصات روتينية لتعداد الدم الكامل ووظائف الكلى. أظهرت النتائج أن نسبة كبيرة من المرضى (55.7%) كانوا يعانون من قصور قلب مع الحفاظ على الكسر القذفي (HFpEF)، بينما 28.2% كانوا يعانون من قصور قلب مع انخفاض الكسر القذفي (HFrEF). وكانت النسبة الأقل (9.9%) تعاني من قصور قلب مع كسر قذفي متوسط المدى (HFmrEF)، و6.1% كان لديهم كسر قذفي طبيعي.   الاستنتاجات: تظهر متلازمة القلب والكبد مجموعة واسعة من العلامات والأعراض والانحرافات في الفحوصات المخبرية، وهي أكثر انتشاراً بين مرضى قصور القلب الذكور وفي الفئة العمرية 1.KhademE.,ToosiM.N.,IlkhaniR.Liver-HeartInter-RelationshipinFattyLiver
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2.AsraniN.S.,FreeseD.K.,PhillipsS.D.,HeimbachJ.,AsraniS.K.,WarnesC.A.,
Kamath P.S. Congenital heart disease and the
liver. Hepatology. 2012;56:1160–1169. doi: 10.1002/hep.25692. [PubMed]
[CrossRef] [GoogleScholar]
3.GiallourakisC.C.,RosenbergP.M.,FriedmanL.S.Theliverinheartfailure. Clin.
LiverDis. 2002;6:947–967.doi: 10.1016/S1089-3261(02)00056-9. [PubMed]
[CrossRef] [GoogleScholar]
4.DeGonzalezA.K.K.,LefkowitchJ.H.HeartDiseaseandthe
Liver. Gastroenterol. Clin. N. Am. 2017;46:421–435.
doi: 10.1016/j.gtc.2017.01.012. [PubMed][CrossRef] [GoogleScholar]
5.MyersR.P.,CeriniR.,SayeghR.,MoreauR.,DegottC.,LebrecD.,LeeS.S.
Cardiachepatopathy:Clinical,hemodynamic,andhistologiccharacteristics
and correlations. Hepatology. 2003;37:393–400.
doi: 10.1053/jhep.2003.50062. [PubMed][CrossRef] [GoogleScholar]
6.TéllezL.,Rodriguez-SantiagoE.,AlbillosA.Fontan-AssociatedLiverDisease:
A Review. Ann. Hepatol. 2018;17:192–204.
doi: 10.5604/01.3001.0010.8634. [PubMed][CrossRef] [GoogleScholar]
7.FauciA.S.,BraunwaldE.,HauserS.L.,LongoD.L.,JamesonJ.,Loscalzo
J. Harrison’sPrinciplesofInternalMedicine. Volume2McGraw-HillMedical;
NewYork,NY,USA:2008. [GoogleScholar]
8.KiesewetterC.H.,SheronN.,VettukattillJ.J.,HackingN.,StedmanB.,
Millward-SadlerH.,HawM.,CopeR.,SalmonA.P.,SivaprakasamM.C.,etal.
HepaticchangesinthefailingFontancirculation. Heart. 2006;93:579–584.
doi: 10.1136/hrt.2006.094516. [PMC free article] [PubMed]
[CrossRef] [GoogleScholar]
9.WeisbergI.S.,JacobsonI.M.CardiovascularDiseasesandtheLiver. Clin.
Liver Dis. 2011;15:1–20. doi: 10.1016/j.cld.2010.09.010. [PubMed]
[CrossRef] [GoogleScholar]
10.VasconcelosL.A.B.A.,DeAlmeidaE.A.,BachurL.F.Clinicalevaluationand
hepaticlaboratoryassessmentinindividualswithcongestiveheart
failure. Arq. Bras. Cardiol. 2007;88:590–595. doi: 10.1590/S0066
782X2007000500015. [PubMed][CrossRef] [GoogleScholar]
11.PoelzlG.,EberlC.,AchrainerH.,DoerlerJ.,PachingerO.,FrickM.,UlmerH.
PrevalenceandPrognosticSignificanceofElevatedγ-Glutamyltransferasein
Chronic Heart Failure. Circ. Heart Fail. 2009;2:294–302.
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doi: 10.1161/CIRCHEARTFAILURE.108.826735. [PubMed][CrossRef] [Google
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Health. 2013;42:648–649. [PMCfreearticle] [PubMed] [GoogleScholar]
2.AsraniN.S.,FreeseD.K.,PhillipsS.D.,HeimbachJ.,AsraniS.K.,WarnesC.A.,
Kamath P.S. Congenital heart disease and the
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[CrossRef] [GoogleScholar]
3.GiallourakisC.C.,RosenbergP.M.,FriedmanL.S.Theliverinheartfailure. Clin.
LiverDis. 2002;6:947–967.doi: 10.1016/S1089-3261(02)00056-9. [PubMed]
[CrossRef] [GoogleScholar]
4.DeGonzalezA.K.K.,LefkowitchJ.H.HeartDiseaseandthe
Liver. Gastroenterol. Clin. N. Am. 2017;46:421–435.
doi: 10.1016/j.gtc.2017.01.012. [PubMed][CrossRef] [GoogleScholar]
5.MyersR.P.,CeriniR.,SayeghR.,MoreauR.,DegottC.,LebrecD.,LeeS.S.
Cardiachepatopathy:Clinical,hemodynamic,andhistologiccharacteristics
and correlations. Hepatology. 2003;37:393–400.
doi: 10.1053/jhep.2003.50062. [PubMed][CrossRef] [GoogleScholar]
6.TéllezL.,Rodriguez-SantiagoE.,AlbillosA.Fontan-AssociatedLiverDisease:
A Review. Ann. Hepatol. 2018;17:192–204.
doi: 10.5604/01.3001.0010.8634. [PubMed][CrossRef] [GoogleScholar]
7.FauciA.S.,BraunwaldE.,HauserS.L.,LongoD.L.,JamesonJ.,Loscalzo
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NewYork,NY,USA:2008. [GoogleScholar]
8.KiesewetterC.H.,SheronN.,VettukattillJ.J.,HackingN.,StedmanB.,
Millward-SadlerH.,HawM.,CopeR.,SalmonA.P.,SivaprakasamM.C.,etal.
HepaticchangesinthefailingFontancirculation. Heart. 2006;93:579–584.
doi: 10.1136/hrt.2006.094516. [PMC free article] [PubMed]
[CrossRef] [GoogleScholar]
9.WeisbergI.S.,JacobsonI.M.CardiovascularDiseasesandtheLiver. Clin.
Liver Dis. 2011;15:1–20. doi: 10.1016/j.cld.2010.09.010. [PubMed]
[CrossRef] [GoogleScholar]
10.VasconcelosL.A.B.A.,DeAlmeidaE.A.,BachurL.F.Clinicalevaluationand
hepaticlaboratoryassessmentinindividualswithcongestiveheart
failure. Arq. Bras. Cardiol. 2007;88:590–595. doi: 10.1590/S0066
782X2007000500015. [PubMed][CrossRef] [GoogleScholar]
11.PoelzlG.,EberlC.,AchrainerH.,DoerlerJ.,PachingerO.,FrickM.,UlmerH.
PrevalenceandPrognosticSignificanceofElevatedγ-Glutamyltransferasein
Chronic Heart Failure. Circ. Heart Fail. 2009;2:294–302.
References
52
doi: 10.1161/CIRCHEARTFAILURE.108.826735. [PubMed][CrossRef] [Google
Scholar]المتوسطة. كما تبين أن الإصابة بمتلازمة القلب والكبد تكون أكثر احتمالاً لدى المرضى الذين يعانون من انخفاض الكسر القذفي.  

المراجع

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التنزيلات

منشور

2022-12-28

إصدار

القسم

الانتاج العلمي للكادر الاكاديمي وطلبة كلية الصيدلة السريرية بجامعة 21 سبتمبر للعلوم الطبية والتطبيقية

الفئات

كيفية الاقتباس

ﺍﻟﻌﻮﺩﻱ ﺷ., الخولي ا., ﺭﻳﺸﺎﻥ ﺍ., ﺑﺎﻛﺮ ﺇ., ﺧﺎﻭﺯ ﺍ., ﺍﻟﻘﻌﻴﺶ ﺍ., ﺧﺎﻭﺯ ﺍ., ﺑﺎﺩﻱ ﻏ., ﺍﻟﺒﻜﻴﺮ ﺳ., ﻣﻬﺪﻱ ﻋ., ﻣﺪﻫﻴﺶ ﻟ., ﺍﻟﺴﻴﺎﻏﻲ ﻃ., ﻗﺎﺳﻢ ﻫ., & ﺍﻟﻌﺰﻋﺰﻱ ﻧ. (2022). المتلازمة القلبية الكبدية بين مرضى قصور القلب في صنعاء اليمن. المستودع الرقمي للانتاج العلمي بجامعة 21 سبتمبر للعلوم الطبية والتطبيقية, 3(1), 1-94. https://doi.org/10.65693/irss.2022.v3i1.305

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