Jeong Phil Ho, Baik Soon Koo, Choi Yeun Jong, Park Dong Hoon, Kim Moon Young, Kim Hyun Soo, Lee Dong Ki, Kwon Sang Ok, Kim Young Ju, Park Joong Wha, Kim Nam Dong
Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Korea.
Taehan Kan Hakhoe Chi. 2002 Sep;8(3):264-70.
BACKGROUND/AIMS: This prospective study aimed to determine if Doppler ultrasonography can be representative of hepatic venous pressure gradient (HVPG) in assessing the severity of portal hypertension and response to drug reducing portal pressure.
The HVPG and the parameters of Doppler ultrasonography including portal venous velocity (PVV) and splenic venous velocity, the pulsatility and resistive index of hepatic, splenic and renal arteries were measured in 105 patients with liver cirrhosis. In 31 patients the changes of hepatic venous pressure gradient and portal venous velocity after administration of terlipressin were evaluated. The patients who showed a reduction in HVPG of more than 20% of the baseline were defined as responders to terlipressin.
Any Doppler ultrasonographic parameters did not correlate with HVPG. Both HVPG and PVV showed a highly significant reduction after the administration of terlipressin(-28.3 +/- 3.9%, -31.2 +/- 2.2% respectively). However, PVV decreased significantly not only in responders(31.7 +/- 2.4%) but also in nonresponders(29.5 +/- 6.1%).
Doppler ultrasonography can not be representative of HVPG in assessing the severity of portal hypertension and response to drug reducing portal pressure in liver cirrhosis.
背景/目的：本前瞻性研究旨在确定在评估门静脉高压的严重程度以及对降低门静脉压力药物的反应时，多普勒超声检查能否代表肝静脉压力梯度（HVPG）。
对105例肝硬化患者测量了HVPG以及多普勒超声检查参数，包括门静脉流速（PVV）和脾静脉流速，肝、脾和肾动脉的搏动指数和阻力指数。对31例患者评估了给予特利加压素后肝静脉压力梯度和门静脉流速的变化。将HVPG较基线降低超过20%的患者定义为对特利加压素反应者。
任何多普勒超声检查参数均与HVPG无相关性。给予特利加压素后，HVPG和PVV均显著降低（分别为-28.3±3.9%，-31.2±2.2%）。然而，PVV不仅在反应者中显著降低（31.7±2.4%），在无反应者中也显著降低（29.5±6.1%）。
在评估肝硬化门静脉高压的严重程度以及对降低门静脉压力药物的反应时，多普勒超声检查不能代表HVPG。
