Berzigotti A, Castaldini N, Rossi V, Magalotti D, Tiani C, Zappoli P, Zoli M
Dip. Medicina Interna, Cardioangiologia, Epatologia, University of Bologna, Italy.
Ultraschall Med. 2009 Jun;30(3):277-85. doi: 10.1055/s-2008-1027742. Epub 2009 Feb 27.
To prospectively assess if ageing itself induces modifications of the impedance indices (resistance and pulsatility indexes) of hepatic, splenic, superior mesenteric and renal arteries in patients with liver cirrhosis.
78 consecutive patients with cirrhosis (41 males, 37 females, Child-Pugh score 7 [range 5 - 12]) were studied by colour-Doppler ultrasound. The resistance index (RI) and pulsatility index (PI) were determined in the main hepatic artery, intraparenchymal branches of hepatic, splenic, and renal arteries, and superior mesenteric artery; clinical data were simultaneously collected. Logistic regression analysis was performed to assess the relative impact of age, severity of liver disease and other relevant variables on the increase of impedance indices. Linear regression analysis was used to identify a coefficient to adjust RIs and PIs to age.
Resistance and pulsatility indices of all the vessels studied except of the superior mesenteric artery showed a direct correlation with age (e. g. splenic artery RI: R = 0.520, p < 0.0001), and correlated most strongly with Child-Pugh score (e. g. right renal artery PI: R = 0.462, p < 0.0001). Age was associated independently with increased PI and RI in hepatic, splenic and renal arterial districts. In these vessels, the RI threshold of normality can be adjusted to the decade of age adding a correction of 0.03.
Ageing itself induces an increase of hepatic, splenic and renal impedance indices in cirrhotic patients. The threshold of normality for these indices in cirrhosis should be adjusted according to the patients' age.
前瞻性评估衰老本身是否会导致肝硬化患者肝动脉、脾动脉、肠系膜上动脉和肾动脉的阻抗指数（阻力指数和搏动指数）发生改变。
对78例连续的肝硬化患者（41例男性，37例女性，Child-Pugh评分7分[范围5 - 12分]）进行彩色多普勒超声检查。测定肝总动脉、肝实质内分支动脉、脾动脉、肾动脉及肠系膜上动脉的阻力指数（RI）和搏动指数（PI）；同时收集临床资料。进行逻辑回归分析，以评估年龄、肝病严重程度及其他相关变量对阻抗指数升高的相对影响。采用线性回归分析确定一个系数，用于将RI和PI校正为年龄相关值。
除肠系膜上动脉外，所有研究血管的阻力指数和搏动指数均与年龄呈正相关（例如脾动脉RI：R = 0.520，p < 0.0001），且与Child-Pugh评分相关性最强（例如右肾动脉PI：R = 0.462，p < 0.0001）。年龄独立与肝、脾和肾动脉区域的PI和RI升高相关。在这些血管中，正常RI阈值可根据年龄每十年增加0.03进行校正。
衰老本身会导致肝硬化患者肝、脾和肾阻抗指数升高。肝硬化患者这些指数的正常阈值应根据患者年龄进行调整。
