Nakai A, Sekiya I, Oya A, Koshino T, Araki T
Department of Obstetrics and Gynecology, Tama Nagayama Hospital, Nippon Medical School, Tokyo, Japan. Nakai_Akihito/
Arch Gynecol Obstet. 2002 Jan;266(1):25-9. doi: 10.1007/pl00007495.
The aim of this study was to evaluate whether the dual hepatic blood supply is altered in healthy pregnant women compared with that in nonpregnant women.
Flow wave-forms in common hepatic artery and portal vein were obtained in 67 healthy pregnant women at 10-40 weeks gestation and 22 nonpregnant women by using Doppler ultrasonography.
In the nonpregnant group, the mean (SD) hepatic arterial blood flow, portal venous blood flow, and total liver blood flow were 0.57 (0.31) L/min, 1.25 (0.46) L/min, and 1.82 (0.63) L/min, respectively. In the healthy pregnant group, the portal venous blood flow and total liver blood flow significantly increased after 28 weeks gestation. However, the hepatic arterial blood flow remained unchanged during pregnancy. There was no relationship between the hepatic arterial blood flow and the portal venous blood flow.
The results demonstrated that the hepatic perfusion increased during third trimester compared to nonpregnant level. Because the hepatic arterial blood flow remained unchanged during pregnancy, major determinant of the increase in the hepatic perfusion was the portal venous return. The data suggest that the hepatic arterial and portal venous vascular territories have regulatory mechanisms that allow for independent changes during pregnancy.
本研究旨在评估健康孕妇与非孕妇相比，其肝脏双重血液供应是否发生改变。
采用多普勒超声检查，获取了67名妊娠10 - 40周的健康孕妇及22名非孕妇的肝总动脉和门静脉血流波形。
在非妊娠组中，肝动脉平均（标准差）血流量、门静脉血流量和肝脏总血流量分别为0.57（0.31）升/分钟、1.25（0.46）升/分钟和1.82（0.63）升/分钟。在健康妊娠组中，妊娠28周后门静脉血流量和肝脏总血流量显著增加。然而，妊娠期间肝动脉血流量保持不变。肝动脉血流量与门静脉血流量之间无相关性。
结果表明，与非妊娠水平相比，妊娠晚期肝脏灌注增加。由于妊娠期间肝动脉血流量保持不变，肝脏灌注增加的主要决定因素是门静脉回流。数据表明，肝动脉和门静脉血管区域具有调节机制，可在妊娠期间独立变化。
