Tesar V, Horký K, Jedlicka J, Petrtýl J, Kopecká J, Gregorová I, Marecek Z, Perlík F, Kordac V
I. interní katedra fakulty vseobecného lékarství, Praha.
Cas Lek Cesk. 1990 Jan 26;129(4):117-22.
In 12 patients with cirrhosis of the liver (six with ascites) and six controls the authors made catheterizations of the hepatic veins and portal circulation, assessing concurrently the in cardiac output by thermodilution. The patients with ascitic cirrhosis had, as compared with controls, a significantly higher portohepatic gradient, central venous pressure, mean pressure in the pulmonary artery and also pulmonary capillary wedged pressure and a significantly lower mean arterial pressure and systemic vascular resistance. These patients had also, as compared with controls, a significantly higher concentration of ANF (atrial natriuretic factor) in the pulmonary artery (15.89 +/- 2.26 vs. 8.04 +/- 0.97, p less than 0.01) and in the hepatic vein (7.44 +/- 0.44 vs. 3.91 +/- 0.63, p less than 0.01); the difference between ANF concentrations in the peripheral blood stream was not significant (9.52 +/- 2.46 vs. 5.71 +/- 1.24 n. s.). Patients with ascitic cirrhosis of the liver had a significantly higher calculated cardiac production of ANF than controls (24.36 +/- 3.44 vs. 8.12 +/- 2.9, p less than 0.01); the difference in the splanchnic extraction of ANF between patients with ascitic cirrhosis of the liver (0.46 +/- 0.1) and controls (0.51 +/- 0.06) was not significant. The ANF concentration in the pulmonary artery in patients with cirrhosis of the liver correlated significantly with the central venous pressure (r = 0.677, p = 0.02) and the pressure in the pulmonary artery in a wedged position (r = 0.639, p = 0.03).(ABSTRACT TRUNCATED AT 250 WORDS)
作者对12例肝硬化患者(6例有腹水)和6例对照者进行肝静脉和门静脉循环插管,并通过热稀释法同时评估心输出量。与对照组相比,腹水型肝硬化患者的肝门静脉梯度、中心静脉压、肺动脉平均压以及肺毛细血管楔压显著更高,而平均动脉压和全身血管阻力显著更低。与对照组相比,这些患者的肺动脉(15.89±2.26对8.04±0.97,p<0.01)和肝静脉(7.44±0.44对3.91±0.63,p<0.01)中的心钠素(ANF)浓度也显著更高;外周血流中ANF浓度的差异不显著(9.52±2.46对5.71±1.24,无统计学意义)。腹水型肝硬化患者计算得出的心脏ANF生成量显著高于对照组(24.36±3.44对8.12±2.9,p<0.01);腹水型肝硬化患者(0.46±0.1)与对照组(0.51±0.06)之间ANF的内脏提取差异不显著。肝硬化患者肺动脉中的ANF浓度与中心静脉压(r=0.677,p=0.02)和肺毛细血管楔压(r=0.639,p=0.03)显著相关。(摘要截短于250字)