PDF(Pubmed)
Abstract：
The renin-angiotensin system (RAS) is a complex homeostatic entity with multiorgan systemic and local effects. Traditionally, RAS works in conjunction with the kidney to control effective arterial circulation, systemic vascular resistance, and electrolyte balance. However, chronic hepatic injury and resulting splanchnic dilation may disrupt this delicate balance. The role of RAS in liver disease, however, is even more extensive, modulating hepatic fibrosis and portal hypertension. Recognition of an alternative RAS pathway in the past few decades has changed our understanding of RAS in liver disease, and the concept of opposing vs. \"rebalanced\" forces is an ongoing focus of research. Whether RAS inhibition is beneficial in patients with chronic liver disease appears to be context-dependent, but further study is needed to optimize clinical management and reduce organ-specific morbidity and mortality. This review presents the current understanding of RAS in liver disease, acknowledges areas of uncertainty, and describes potential areas of future investigation.
摘要：
肾素-血管紧张素系统（RAS）是一种复杂的稳态实体，具有多器官系统和局部作用。传统上,RAS与肾脏协同工作以控制有效的动脉循环，全身血管阻力，和电解质平衡。然而,慢性肝损伤和由此导致的内脏扩张可能会破坏这种微妙的平衡。RAS在肝脏疾病中的作用，然而,甚至更广泛，调节肝纤维化和门脉高压。在过去的几十年中，对替代RAS途径的认识改变了我们对肝脏疾病中RAS的理解。反对与反对的概念“重新平衡”的力量是一个持续的研究重点。RAS抑制对慢性肝病患者是否有益似乎取决于上下文，但需要进一步研究以优化临床管理并降低器官特异性发病率和死亡率.这篇综述介绍了目前对RAS在肝脏疾病中的理解。承认不确定的领域，并描述了未来调查的潜在领域。
