Hussain Qurban, Haider Shahbaz, Solangi Noor Muhammad, Ali Liaquat, Liaquat Hammad, Ahmed Fayyaz, Shahbaz Sumera
Medical Unit IV, Medical ICU, Jinnah Postgraduate Medial Centre, Karachi.
J Pak Med Assoc. 2013 May;63(5):604-8.
To observe the changes in Doppler waveform of hepatic vein after the administration of terlipressin, and to assess indirectly the efficacy of the drug to reduce the Hepatic Vein Pressure Gradient and portal pressure.
The quasi-experimental study was conducted at the Jinnah Postgraduate Medical Centre, Karachi, from April 1 to November 25, 2011, and comprised 50 patients with cirrhosis with abnormal Doppler waveform of the hepatic vein. Patients with diseases causing abnormal hepatic vein doppler waveform were excluded. Doppler waveforms were studied for 20 minutes before and for 20 minutes after the administration of terlipressin. Tracings with best waveform before and after injection were saved for analysis. Changes in waveform after vasoactive drug were defined as mild, significant, marked and gross changes. SPSS 10 was used for statistical analysis.
Of the 50 patients, 36 (72%) were males and 14 (28%) females. Commonest waveform was monophasic 38 (76%). Gross changes i.e. turning triphasic from monophasic waveform was observed in 8 (16%) patients. Significant gross changes were seen in 24 (48%) patients. Total number of patients showing improvement in waveform was 36 (72%). In no case, waveform deteriorated after the administration of terlipressin (p = 0.001).
Non-invasive method of observing the improvement of hepatic vein waveform by duplex ultrasound, after more studies, may be an important tool for assessing and monitoring the effects of portal pressure lowering drugs.
观察特利加压素给药后肝静脉多普勒波形的变化，并间接评估该药物降低肝静脉压力梯度和门静脉压力的疗效。
该准实验研究于2011年4月1日至11月25日在卡拉奇真纳研究生医学中心进行，纳入50例肝静脉多普勒波形异常的肝硬化患者。排除由导致肝静脉多普勒波形异常的疾病引起的患者。在给予特利加压素前20分钟和给药后20分钟研究多普勒波形。保存注射前后最佳波形的记录用于分析。血管活性药物给药后波形的变化定义为轻度、显著、明显和总体变化。使用SPSS 10进行统计分析。
50例患者中，男性36例（72%），女性14例（28%）。最常见的波形是单相波，共38例（76%）。8例（16%）患者出现总体变化，即从单相波形转变为三相波形。24例（48%）患者出现显著的总体变化。波形显示改善的患者总数为36例（72%）。在任何情况下，特利加压素给药后波形均未恶化（p = 0.001）。
经过更多研究后，通过双功超声观察肝静脉波形改善的非侵入性方法可能成为评估和监测降低门静脉压力药物效果的重要工具。
