Allam Mohamed A, Elmetwaly Mohamed Toulba, Elwan Hamed Abdelhafiz, Alteby Diaa Mohamed, Soliman Gamal Mohamed, Abu-Alfotuh Atef
Department of Tropical Medicine, Faculty of Medicine, Al-Azhar University, Nasr City, Cairo, Egypt.
J Egypt Soc Parasitol. 2010 Dec;40(3):745-50.
Spontaneous bacterial peritonitis (SBP) is a severe complication of cirrhosis and the role of portal hypertension in the development of SBP has been suggested. This study assessed the portal vein (PV) haemodynamic changes in patients with SBP. The study was conducted on 20 ascitic patients with SBP (GI), 20 ascitic patients without SBP (GII), 20 cirrhotic patients without ascites (GIII) and 20 healthy cross-matched controls (GIV). All groups were subjected to complete clinical assessment and routine laboratory investigations. Portal vein diameter, velocity and congestion index (CI) were assessed by Doppler ultrasound. The results showed no significant difference between SBP patients and ascitic patients without SBP as regard PV diameter, velocity or CI. Portal vein diameter was significantly wider in patients with SBP (14.9 +/- 2.08 mm) and cirrhotic ascites (14.15 +/- 2.3) than normal persons (10.55 +/- 2.24 mm) or cirrhotic compensated patients (13.15 +/- 1.6 mm). The mean velocity of PV was significantly lower in patients with SBP (10.4 +/- 2.11) and ascites (10.7 +/- 2.22) than normal persons (15.35 +/- 2.08) or cirrhotic compensated patients (14 +/- 2.6), with no significant difference between controls and cirrhotic compensated patients. The CI of PV was significantly higher in patients with SBP (0.1825 +/- 0.036) and ascites (0.1743 +/- 0.051) than controls (0.05 +/- 0.050) or cirrhotic compensated patients (0.0955 +/- 0.091). Cirrhotic compensated patients showed significantly wider PV (13.15 +/- 1.6) and higher congestion index (0.0955 +/- 0.091) than normal persons (10.55 +/- 2.24 and 0.05 +/- 0.050 respectively).
自发性细菌性腹膜炎（SBP）是肝硬化的一种严重并发症，门静脉高压在SBP发生中的作用已被提出。本研究评估了SBP患者的门静脉（PV）血流动力学变化。该研究纳入了20例伴有SBP的腹水患者（GI组）、20例不伴有SBP的腹水患者（GII组）、20例无腹水的肝硬化患者（GIII组）和20例健康的交叉配型对照者（GIV组）。所有组均接受了全面的临床评估和常规实验室检查。通过多普勒超声评估门静脉直径、血流速度和充血指数（CI）。结果显示，SBP患者与不伴有SBP的腹水患者在PV直径、血流速度或CI方面无显著差异。SBP患者（14.9±2.08mm）和肝硬化腹水患者（14.15±2.3mm）的门静脉直径显著宽于正常人（10.55±2.24mm）或肝硬化代偿期患者（13.15±1.6mm）。SBP患者（10.4±2.11）和腹水患者（10.7±2.22）的PV平均血流速度显著低于正常人（15.35±2.08）或肝硬化代偿期患者（14±2.6），对照组与肝硬化代偿期患者之间无显著差异。SBP患者（0.1825±0.036）和腹水患者（0.1743±0.051）的PV充血指数显著高于对照组（0.05±0.050）或肝硬化代偿期患者（0.0955±0.091）。肝硬化代偿期患者的PV直径（13.15±1.6）和充血指数（0.0955±0.091）显著宽于和高于正常人（分别为10.55±2.24和0.05±0.050）。
