Friedman H S, Fernando H
Department of Medicine, Long Island College Hospital, Brooklyn 11201.
Alcohol Clin Exp Res. 1992 Oct;16(5):968-70. doi: 10.1111/j.1530-0277.1992.tb01902.x.
The purpose of this study was to determine the relation of the circulatory findings of cirrhosis to hepatic decompensation. Twenty individuals with biopsy-proven cirrhosis and 15 aged-matched controls underwent echocardiographic evaluation of cardiac function. Cardiac dimensions and indices derived from echocardiograms were related to various measures of liver decompensation. Cirrhotics had a higher heart rate, left ventricular end-diastolic volume, left ventricular ejection fraction, and cardiac output and a lower mean blood pressure and peripheral resistance than aged-matched subjects. On multiple regression analyses mean blood pressure, peripheral resistance, and cardiac output were all found to be related to estimates of ascites. Also, cirrhotics with ascites had a lower peripheral resistance than those without this finding.
In clinically stable patients with cirrhosis, the presence of ascites indicates an intense vasodilatory state with a hyperdynamic circulation.
本研究的目的是确定肝硬化的循环系统表现与肝失代偿之间的关系。20例经活检证实为肝硬化的患者和15例年龄匹配的对照者接受了心脏功能的超声心动图评估。超声心动图得出的心脏大小和指标与肝失代偿的各种测量值相关。与年龄匹配的受试者相比,肝硬化患者心率更高、左心室舒张末期容积更大、左心室射血分数更高、心输出量更高,平均血压和外周阻力更低。在多元回归分析中,发现平均血压、外周阻力和心输出量均与腹水评估值相关。此外,有腹水的肝硬化患者外周阻力低于无此表现的患者。
在临床稳定的肝硬化患者中,腹水的存在表明存在强烈的血管舒张状态和高动力循环。