Parikh Sameer
Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
Dig Dis Sci. 2009 Jun;54(6):1178-83. doi: 10.1007/s10620-008-0491-8. Epub 2008 Oct 31.
Portal hypertension is one of the most important complications of chronic liver disease and accounts for significant morbidity and mortality. Measurement of the hepatic venous pressure gradient (HVPG) is a simple, invasive, and reproducible method of assessing portal venous pressure. Measurement of HVPG provides the clinician an estimate of the degree of intrahepatic portal flow resistance, guides therapy for variceal bleeding (primary and secondary prophylaxis), assesses feasibility of resection in patients with hepatocellular cancer, and predicts response to therapy of patients with chronic hepatitis C. Achieving hemodynamic targets of reducing the HVPG to <10 mmHg or a 20% reduction from baseline virtually eliminates complications related to portal hypertension from chronic liver disease. This review explores the role of HVPG measurement in the contemporary treatment of patients with cirrhosis and portal hypertension.
门静脉高压是慢性肝病最重要的并发症之一，可导致显著的发病率和死亡率。肝静脉压力梯度（HVPG）测量是一种评估门静脉压力的简单、有创且可重复的方法。HVPG测量为临床医生提供了肝内门静脉血流阻力程度的估计值，指导静脉曲张出血的治疗（一级和二级预防），评估肝细胞癌患者的切除可行性，并预测慢性丙型肝炎患者的治疗反应。实现将HVPG降至<10 mmHg或较基线降低20%的血流动力学目标，实际上可消除慢性肝病相关的门静脉高压并发症。本综述探讨了HVPG测量在当代肝硬化和门静脉高压患者治疗中的作用。
