Tai D I, Changchien C S, Chen C J, Huang C S, Lo S K, Kuo C H
Liver Unit, Chang Gung Memorial Hospital, Kaohsiung Medical Center, 123, Ta-Pei Road, Niao Sung Hsiang, Kaohsiung Hsien, Taiwan.
J Clin Ultrasound. 2000 Feb;28(2):83-8. doi: 10.1002/(sici)1097-0096(200002)28:2<83::aid-jcu5>3.0.co;2-7.
A wide range of portal vein blood flow velocity (PVV) values can be found in acute hepatitis. We studied course and medical significance of PVV changes in patients with severe acute hepatitis over a 1-year period.
Portal venous hemodynamics were studied by Doppler sonography in 90 patients at study enrollment and 3, 6, and 12 months following an episode of severe acute hepatitis.
Forty-one survivors who had a maximum PVV at enrollment greater than or equal to the value measured at the third month were classified as the "declining PVV" group. Thirty-six survivors who had a maximum PVV at enrollment less than the value measured at the third month were classified as the "rising PVV" group. Thirteen patients died of acute hepatic failure and were classified as the fatality group. The fatality group had significantly lower maximum PVV, worse liver biochemical test results, and a higher prevalence of ascites at enrollment. In contrast, the declining PVV group showed significantly better liver biochemical test results and a lower prevalence of ascites. There was no significant difference in portal vein blood flow between the rising and declining PVV groups since portal vein diameter increased while PVV decreased.
An initially decreased PVV can be found in some patients with severe acute hepatitis and is inversely correlated with the severity of liver damage.
急性肝炎患者门静脉血流速度（PVV）值范围广泛。我们研究了重症急性肝炎患者1年内PVV变化的过程及医学意义。
对90例患者在研究入组时以及重症急性肝炎发作后3、6和12个月通过多普勒超声研究门静脉血流动力学。
41例入组时最大PVV大于或等于第3个月测量值的幸存者被归类为“PVV下降”组。36例入组时最大PVV小于第3个月测量值的幸存者被归类为“PVV上升”组。13例患者死于急性肝衰竭，被归类为死亡组。死亡组入组时最大PVV显著更低，肝脏生化检查结果更差，腹水患病率更高。相比之下，PVV下降组肝脏生化检查结果显著更好，腹水患病率更低。PVV上升组和下降组之间门静脉血流无显著差异，因为门静脉直径增加而PVV降低。
一些重症急性肝炎患者最初可出现PVV降低，且与肝损伤严重程度呈负相关。
