血钙与肝硬化食管胃底静脉曲张破裂出血的 关联：从机制到临床启示

Association of Serum Calcium with Gastroesophageal Variceal Bleeding in Cirrhosis: From Mechanism to Clinical Implications

摘要: 肝硬化食管胃底静脉曲张破裂出血(GEVB)是肝硬化失代偿期的严重并发症，其发生发展与机体内多种病理生理机制密切相关。血钙作为人体重要的电解质，不仅参与骨骼代谢、神经肌肉调节等生理过程，在调控血小板功能、血管张力及凝血过程中均扮演关键角色，其稳态失衡可能与GEVB的发生存在潜在联系。本综述系统阐述了血钙水平与肝硬化GEVB关联潜在的病理生理机制、现有临床证据，以期为改善肝硬化患者预后提供新的视角和潜在的干预靶点。

Abstract: Gastroesophageal variceal bleeding (GEVB) is a serious complication of decompensated cirrhosis, and its occurrence and development are closely related to a variety of pathophysiological mechanisms in the body. As an important electrolyte in the human body, serum calcium not only participates in physiological processes such as bone metabolism and neuromuscular regulation, but also plays a key role in the regulation of platelet function, vascular tone and coagulation. The imbalance of serum calcium homeostasis may be potentially related to the occurrence of GEVB. This review systematically describes the potential pathophysiological mechanism and existing clinical evidence of the association between serum calcium level and GEVB in cirrhosis, in order to provide a new perspective and potential intervention targets for improving the prognosis of patients with cirrhosis.