Thalheimer U, Leandro G, Samonakis D N, Triantos C K, Patch D, Burroughs A K
Liver Transplantation and Hepatobiliary Medicine Unit, Royal Free Hospital, Pond Street, NW3 2QG London, UK; Internal Medicine Dept., Policlinico G.B. Rossi, Piazzale L.A. Scuro, Verona, Italy.
Dig Liver Dis. 2005 Aug;37(8):601-8. doi: 10.1016/j.dld.2005.02.009.
Measuring wedged hepatic venous pressure and hepatic venous pressure gradient as indices of portal pressure is being increasingly used in assessing the prognosis and response to pharmacological treatment for portal hypertension in cirrhotic patients.
To re-evaluate the agreement and correlation between wedged hepatic pressures and directly measured portal pressures.
Medline search for studies comparing direct portal with wedged hepatic pressure measurement and assessment of correlation and agreement of the pooled data.
Eleven suitable studies included 320 patients. Coefficient of determination (r2) was 0.87 in all patients, 0.87 in 102 patients with alcoholic liver disease, 0.83 in 88 patients with non-alcoholic liver disease and 0.75 in 53 patients with hepatitis C-related liver disease. Coefficient of determination was 0.85 in the 194 patients in whom a wedge catheter and 0.90 in the 113 patients in whom a balloon catheter was used. Agreement according to the method of Bland and Altman was also found to be good, with only 4-8% of the measurements outside 2 standard deviations.
Wedged hepatic pressure measurement correlates well with direct portal pressure measurement and the agreement is sufficiently good to use this as a surrogate measurement.
测量楔入式肝静脉压力和肝静脉压力梯度作为门静脉压力指标，在评估肝硬化患者门静脉高压的预后及药物治疗反应中应用越来越广泛。
重新评估楔入式肝静脉压力与直接测量的门静脉压力之间的一致性和相关性。
通过医学文献数据库检索比较直接门静脉压力测量与楔入式肝静脉压力测量的研究，并对汇总数据的相关性和一致性进行评估。
11项合适的研究纳入了320例患者。所有患者的决定系数（r2）为0.87，102例酒精性肝病患者为0.87，88例非酒精性肝病患者为0.83，53例丙型肝炎相关肝病患者为0.75。使用楔入导管的194例患者的决定系数为0.85，使用球囊导管的113例患者为0.90。根据布兰德-奥特曼方法得出的一致性也良好，仅有4%-8%的测量值超出2个标准差。
楔入式肝静脉压力测量与直接门静脉压力测量相关性良好，一致性足以将其用作替代测量方法。
