Su Zhong-Zhen, Shan Hong, Ke Wei-Min, He Bing-Jun, Zheng Rong-Qin
Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China.
World J Gastroenterol. 2008 Feb 7;14(5):795-9. doi: 10.3748/wjg.14.795.
To evaluate portalsystemic hemodynamic changes in chronic severe hepatitis B.
Hemodynamic parameters included portal vein diameter (PVD), portal vein peak velocity (PVPV), portal vein volume (PVV), spleen length (SPL), spleen vein diameter (SPVD), spleen vein volume (SPVV) and umbilical vein recanalization. They were measured by Color Doppler ultrasonography in 36 patients with chronic severe hepatitis B, compared with 51 normal controls, 61 patients with chronic hepatitis B, 46 patients with compensable cirrhosis, and 36 patients with decompensable cirrhosis.
In the group of chronic severe hepatitis B, PVD (12.38 +/- 1.23 mm) was significantly different from the normal control, compensable cirrhosis and decompensable cirrhosis groups (P = 0.000-0.026), but not significantly different from the chronic hepatitis group. PVPV (16.15 +/- 3.82 cm/s) dropped more significantly in the chronic severe hepatitis B group than the normal control, chronic hepatitis B and compensable cirrhosis groups (P = 0.000-0.011). PVV (667.53 +/- 192.83 mL/min) dropped significantly as compared with the four comparison groups (P = 0.000-0.004). SPL (120.42 +/- 18.36 mm) and SPVD (7.52 +/- 1.52 mm) were longer in the normal control and chronic hepatitis B groups (P = 0.000-0.009), yet they were significantly shorter than those in the decompensable cirrhosis group (P = 0.000). SPVV (242.51 +/- 137.70 mL/min) was also lower than the decompensable cirrhosis group (P = 0.000). The umbilical vein recanalization rate (75%) was higher than the chronic hepatitis B and compensable cirrhosis groups. In the course of progression from chronic hepatitis to decompensable cirrhosis, PVD, SPL and SPVD gradually increased and showed significant differences between every two groups (P = 0.000-0.002).
Patients with chronic severe hepatitis B have a tendency to develop acute portal hypertension, resulting in significantly reduced portal vein perfusion. Observation of the portalsystemic hemodynamic changes may be contributed to the disease progression of chronic liver disease.
评估慢性重型乙型肝炎患者的门体循环血流动力学变化。
血流动力学参数包括门静脉直径（PVD）、门静脉峰值流速（PVPV）、门静脉容积（PVV）、脾脏长度（SPL）、脾静脉直径（SPVD）、脾静脉容积（SPVV）及脐静脉重新开放情况。采用彩色多普勒超声对36例慢性重型乙型肝炎患者进行测量，并与51例正常对照者、61例慢性乙型肝炎患者、46例代偿期肝硬化患者及36例失代偿期肝硬化患者进行比较。
慢性重型乙型肝炎组的PVD（12.38±1.23mm）与正常对照组、代偿期肝硬化组及失代偿期肝硬化组相比差异有统计学意义（P = 0.000 - 0.026），但与慢性乙型肝炎组相比差异无统计学意义。慢性重型乙型肝炎组的PVPV（16.15±3.82cm/s）较正常对照组、慢性乙型肝炎组及代偿期肝硬化组下降更显著（P = 0.000 - 0.011）。PVV（667.53±192.83mL/min）与四个对照组相比均显著下降（P = 0.000 - 0.004）。正常对照组及慢性乙型肝炎组的SPL（120.42±18.36mm）和SPVD（7.52±1.52mm）较长（P = 0.000 - 0.009），但显著短于失代偿期肝硬化组（P = 0.000）。SPVV（242.51±137.70mL/min）也低于失代偿期肝硬化组（P = 0.000）。脐静脉重新开放率（75%）高于慢性乙型肝炎组及代偿期肝硬化组。在从慢性肝炎进展至失代偿期肝硬化的过程中，PVD、SPL及SPVD逐渐增加，且每两组之间差异有统计学意义（P = 0.000 - 0.002）。
慢性重型乙型肝炎患者有发生急性门静脉高压的倾向，导致门静脉灌注显著减少。观察门体循环血流动力学变化可能有助于了解慢性肝病的疾病进展。
