韩国多中心回顾性研究：肝硬化患者肝静脉压力梯度与首次静脉曲张出血的关系。
Relationship between the hepatic venous pressure gradient and first variceal hemorrhage in patients with cirrhosis: a multicenter retrospective study in Korea.
机构信息
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea.
出版信息
Clin Mol Hepatol. 2012 Dec;18(4):391-6. doi: 10.3350/cmh.2012.18.4.391. Epub 2012 Dec 21.
BACKGROUND/AIMS: Variceal hemorrhage is one of the major complications of cirrhosis and is associated with significant mortality and morbidity. The development of gastroesophageal varices and variceal hemorrhage is the most direct consequence of portal hypertension. Correlations between the hepatic venous pressure gradient (HVPG) and first variceal hemorrhage were examined.
METHODS
Patients with cirrhosis who underwent HVPG measurement between July 2009 and September 2010 were enrolled (n=535). All patients underwent esophagogastroduodenoscopy to enable the evaluation of gastroesophageal varices.
RESULTS
The HVPG for all patients was 16.46±7.05 mmHg (mean±SD), and was significantly higher among those with first variceal hemorrhage than in those without it. The HVPG was significantly correlated with both Child-Turcotte-Pugh (r=0.488, P<0.001) and Model for End-stage Liver Disease (r=0.478, P<0.001) scores. An HVPG value of 11 mmHg was predictive of first variceal hemorrhage with a sensitivity of 92.4% and a specificity of 27.7%.
CONCLUSIONS
The HVPG was higher in patients with first variceal hemorrhage than in those without it.
背景/目的：静脉曲张出血是肝硬化的主要并发症之一，与较高的病死率和发病率相关。胃食管静脉曲张和静脉曲张出血的发生是门静脉高压最直接的后果。本研究旨在探讨肝静脉压力梯度（HVPG）与首次静脉曲张出血之间的相关性。
方法
2009 年 7 月至 2010 年 9 月期间，我们招募了接受 HVPG 测量的肝硬化患者（n=535）。所有患者均接受了食管胃十二指肠镜检查，以评估胃食管静脉曲张。
结果
所有患者的 HVPG 为 16.46±7.05mmHg（平均值±标准差），首次静脉曲张出血患者的 HVPG 明显高于无首次静脉曲张出血的患者。HVPG 与 Child-Turcotte-Pugh 评分（r=0.488，P<0.001）和终末期肝病模型评分（r=0.478，P<0.001）显著相关。HVPG 值为 11mmHg 时，对首次静脉曲张出血具有 92.4%的敏感性和 27.7%的特异性。
结论
首次静脉曲张出血患者的 HVPG 高于无首次静脉曲张出血的患者。
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