蛋白丢失性肠病——心血管病诊治中被忽视的一隅

胡崧, 谭江山, 朱永建, 等. 蛋白丢失性肠病——心血管病诊治中被忽视的一隅[J]. 临床心血管病杂志, 2020, 36(11): 1061-1065. doi: 10.13201/j.issn.1001-1439.2020.11.020
引用本文: 胡崧, 谭江山, 朱永建, 等. 蛋白丢失性肠病——心血管病诊治中被忽视的一隅[J]. 临床心血管病杂志, 2020, 36(11): 1061-1065. doi: 10.13201/j.issn.1001-1439.2020.11.020
HU Song, TAN Jiangshan, ZHU Yongjian, et al. Protein losing enteropathy-neglected in the diagnosis and treatment of cardiovascular diseases[J]. J Clin Cardiol, 2020, 36(11): 1061-1065. doi: 10.13201/j.issn.1001-1439.2020.11.020
Citation: HU Song, TAN Jiangshan, ZHU Yongjian, et al. Protein losing enteropathy-neglected in the diagnosis and treatment of cardiovascular diseases[J]. J Clin Cardiol, 2020, 36(11): 1061-1065. doi: 10.13201/j.issn.1001-1439.2020.11.020

蛋白丢失性肠病——心血管病诊治中被忽视的一隅

  • 基金项目:

    中国医学科学院医学与健康科技创新工程经费资助(No:2017-I2M-3-003)

详细信息
    通讯作者: 华潞,E-mail:ethannan@126.com
  • 中图分类号: R541

Protein losing enteropathy-neglected in the diagnosis and treatment of cardiovascular diseases

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  • 蛋白丢失性肠病(PLE)是由多种原发性疾病导致大量蛋白质从肠道丢失的临床综合征,最常继发于胃肠道疾病和心血管疾病。PLE的发生发展与心血管原发疾病密切相关,PLE目前在心血管领域整体认识度较低,未能及时诊断PLE,导致持续或难以纠正的低蛋白血症,原发疾病也可能随PLE的发展而逐渐复杂化,从而严重影响患者的生存质量和预后。本文详述了心血管疾病相关PLE的发病特点和机制,以及诊断和治疗,以期提高PLE的知晓率、诊断率和治疗率,改善患者的生活质量和预后。
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  • [1]

    Arques S.Human serum albumin in cardiovascular diseases[J].Eur J Intern Med,2018,52:8-12.

    [2]

    Akirov A,Masri-Iraqi H,Atamna A,et al.Low albumin levels are associated with mortality risk in hospitalized patients[J].Am J Med,2017,130(12):1465.e11-1465.e19.

    [3]

    Umar SB,DiBaise JK.Protein-losing enteropathy:case illustrations and clinical review[J].Am J Gastroenterol,2010,105(1):43-49.

    [4]

    Kreisel W,Ruf G,Salm R,et al.Protein-losing pseudomembranous colitis with cap polyposis-like features[J].World J Gastroenterol,2017,23(16):3003-3010.

    [5]

    Braamskamp MJ,Dolman KM,Tabbers MM.Clinical practice.Protein-losing enteropathy in children[J].Eur J Pediatr,2010,169(10):1179-1185.

    [6]

    Stephen J,Vilboux T,Haberman Y,et al.Congenital protein losing enteropathy:an inborn error of lipid metabolism due to DGAT1 mutations[J].Eur J Hum Genet,2016,24(9):1268-1273.

    [7]

    Kurolap A,Eshach-Adiv O,Gonzaga-Jauregui C,et al.Establishing the role of PLVAP in protein-losing enteropathy:a homozygous missense variant leads to an attenuated phenotype[J].J Med Genet,2018,55(11):779-784.

    [8]

    Ozen A,Comrie WA,Ardy RC,et al.CD55 deficiency,early-onset protein-losing enteropathy,and thrombosis[J].N Engl J Med,2017,377(1):52-61.

    [9]

    Davidson JD,Waldmann TA,Goodman DS,et al.Protein-losing gastroenteropathy in congestive heart-failure[J].Lancet,1961,1(7183):899-902.

    [10]

    Schleiger A,Ovroutski S,Peters B,et al.Treatment strategies for protein-losing enteropathy in Fontan-palliated patients[J].Cardiol Young,2020,30(5):698-709.

    [11]

    Rychik J,Atz AM,Celermajer DS,et al.Evaluation and management of the child and adult with fontan circulation:a scientific statement from the American Heart Association[J].Circulation,2019:CIR0000000000000696.

    [12]

    Al Balushi A,Mackie AS.Protein-losing enteropathy following fontan palliation[J].Can J Cardiol,2019,35(12):1857-1860.

    [13]

    Johnson JN,Driscoll DJ,O'Leary PW.Protein-losing enteropathy and the Fontan operation[J].Nutr Clin Pract,2012,27(3):375-384.

    [14]

    Mertens L,Hagler DJ,Sauer U,et al.Protein-losing enteropathy after the Fontan operation:an international multicenter study.PLE study group[J].J Thorac Cardiovasc Surg,1998,115(5):1063-1073.

    [15]

    Feldt RH,Driscoll DJ,Offord KP,et al.Protein-losing enteropathy after the Fontan operation[J].J Thorac Cardiovasc Surg,1996,112(3):672-680.

    [16]

    Silvilairat S,Cabalka AK,Cetta F,et al.Protein-losing enteropathy after the Fontan operation:associations and predictors of clinical outcome[J].Congenit Heart Dis,2008,3(4):262-268.

    [17]

    Ohuchi H,Yasuda K,Miyazaki A,et al.Haemodynamic characteristics before and after the onset of protein losing enteropathy in patients after the Fontan operation[J].Eur J Cardiothorac Surg,2013,43(3):e49-57.

    [18]

    Breatnach CR,Cleary A,Prendiville T,et al.Prevalence of subclinical enteric alpha-1-antitrypsin loss in children with univentricular circulation following total cavopulmonary connection[J].Pediatr Cardiol,2018,39(1):33-37.

    [19]

    Meijers BK,Schalla S,Eerens F,et al.Protein-losing enteropathy in association with constrictive pericarditis[J].Int J Cardiovasc Imaging,2006,22(3-4):389-392.

    [20]

    Gursu HA,Varan B,Erdogan I.Use of oral budesonide in the management of protein-losing enteropathy due to restrictive cardiomyopathy[J].Cardiol Young,2014,24(4):764-746.

    [21]

    Lee LC,Wong R,Raju GC,et al.Protein-losing enteropathy post-valvular surgery with severe tricuspid regurgitation in Subutex-related endocarditis[J].Singapore Med J,2009,50(4):e124-126.

    [22]

    Melenovsky V,Kubanek M,Kacer P.Protein-losing enteropathy in an adult with non-ischaemic cardiomyopathy:complete reversal by heart transplantation[J].ESC Heart Fail,2018,5(5):842-845.

    [23]

    Ohira H,Tsujino I,Sakaue S,et al.Recovery of protein-losing enteropathy after living-donor lobar lung transplantation in primary pulmonary hypertension[J].J Heart Lung Transplant,2006,25(4):486-488.

    [24]

    Elli L,Topa M,Rimondi A.Protein-losing enteropathy[J].Curr Opin Gastroenterol,2020,36(3):238-244.

    [25]

    Desai AP,Guvenc BH,Carachi R.Evidence for medium chain triglycerides in the treatment of primary intestinal lymphangiectasia[J].Eur J Pediatr Surg,2009,19(4):241-245.

    [26]

    John AS,Johnson JA,Khan M,et al.Clinical outcomes and improved survival in patients with protein-losing enteropathy after the Fontan operation[J].J Am Coll Cardiol,2014,64(1):54-62.

    [27]

    贾静静,赵劲东,董平栓,等.补充维生素D对心力衰竭患者临床作用的Meta分析[J].临床心血管病杂志,2018,34(2):136-141.

    [28]

    Bejiqi R,Retkoceri R,Zeka N,et al.Treatment of children with protein-losing enteropathy after fontan and other complex congenital heart disease procedures in condition with limited human and technical resources[J].Mater Sociomed,2014,26(1):39-42.

    [29]

    赵跃华,孟小敏,李向欣,等.心力衰竭诊断与药物治疗的研究进展[J].临床心血管病杂志,2020,36(4):382-386.

    [30]

    廖玉华,杨杰孚,张健,等.舒张性心力衰竭诊断和治疗专家共识[J].临床心血管病杂志,2020,36(1):1-10.

    [31]

    Thacker D,Patel A,Dodds K,et al.Use of oral budesonide in the management of protein-losing enteropathy after the Fontan operation[J].Ann Thorac Surg,2010,89(3):837-842.

    [32]

    Therrien J,Webb GD,Gatzoulis MA.Reversal of protein losing enteropathy with prednisone in adults with modified fontan operations:long term palliation or bridge to cardiac transplantation?[J].Heart,1999,82(2):241-243.

    [33]

    Schumacher KR,Cools M,Goldstein BH,et al.Oral budesonide treatment for protein-losing enteropathy in Fontan-palliated patients[J].Pediatr Cardiol,2011,32(7):966-971.

    [34]

    Donnelly JP,Rosenthal A,Castle VP,et al.Reversal of protein-losing enteropathy with heparin therapy in three patients with univentricular hearts and Fontan palliation[J].J Pediatr,1997,130(3):474-478.

    [35]

    Kuroiwa G,Takayama T,Sato Y,et al.Primary intestinal lymphangiectasia successfully treated with octreotide[J].J Gastroenterol,2001,36(2):129-132.

    [36]

    John AS,Phillips SD,Driscoll DJ,et al.The use of octreotide to successfully treat protein-losing enteropathy following the Fontan operation[J].Congenit Heart Dis,2011,6(6):653-656.

    [37]

    Hofmann AF.Increased deoxycholic acid absorption and gall stones in acromegalic patients treated with octreotide:more evidence for a connection between slow transit constipation and gall stones[J].Gut,2005,54(5):575-578.

    [38]

    Meadows J,Jenkins K.Protein-losing enteropathy:integrating a new disease paradigm into recommendations for prevention and treatment[J].Cardiol Young,2011,21(4):363-377.

    [39]

    Vyas H,Driscoll DJ,Cabalka AK,et al.Results of transcatheter Fontan fenestration to treat protein losing enteropathy[J].Catheter Cardiovasc Interv,2007,69(4):584-589.

    [40]

    Latson L.Once more unto the breach:a new treatment paradigm for protein-losing enteropathy[J].J Am Coll Cardiol,2017,69(24):2938-2940.

    [41]

    Itkin M,Piccoli DA,Nadolski G,et al.Protein-losing enteropathy in patients with congenital heart disease[J].J Am Coll Cardiol,2017,69(24):2929-2937.

    [42]

    Müller C,Globits S,Glogar D,et al.Constrictive pericarditis without typical haemodynamic changes as a cause of oedema formation due to protein-losing enteropathy[J].Eur Heart J,1991,12(10):1140-1143.

    [43]

    Moriyama H,Kohno T,Nishiyama T,et al.Constrictive pericarditis and protein-losing enteropathy:is extremely severe hypoalbuminemia reversible by pericardiectomy?[J].Circ Heart Fail,2016,9(12):110-122.

    [44]

    Wilkinson P,Pinto B,Senior JR.Reversible protein-losing enteropathy with intestinal lymphangiectasia secondary to chronic constrictive pericarditis[J].N Engl J Med,1965,273(22):1178-1181.

    [45]

    Hiew C,Collins N,Foy A,et al.Successful surgical treatment of protein-losing enteropathy complicating rheumatic tricuspid regurgitation[J].Heart Lung Circ,2008,17(1):73-75.

    [46]

    Yamanaka O,Ozaki H,Kanoh T,et al.A case of isolated tricuspid regurgitation associated with protein-losing gastroenteropathy[J].Kokyu To Junkan,1989,37(3):351-356.

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收稿日期:  2020-06-13

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