Petrtýl J, Brůha R, Urbánek P, Mareček Z, Kaláb M
IV. interní klinika 1. lékařské fakulty UK a VFVN Praha.
Vnitr Lek. 2013 Jul;59(7):587-90.
Hepatic vein catheterisation and portal hypertension assessment using the value of portal hepatic gradient (HVPG) is currently a method of choice.
In our paper we shall compare HVPG with the so called direct gradient - using the difference in pressure in the portal vein and free hepatic vein in 5 groups of patients with liver cirrhosis.
Hepatic vein catheterisation is reliable for assessing the portal hypertension in the group of patients with liver cirrhosis of ethylic etiology. In patients with liver cirrhosis resulting from hepatitis B, Wilsons disease or primary biliary cirrhosis, a statistically significant difference between HVPG and the direct gradient has been found. In patients with liver cirrhosis resulting from hepatitis C the obtained values differed but without statistical significance.
In catheterisation of hepatic veins the HVPG value in liver cirrhosis with a presinusoidal component may be reduced, which has to be primarily taken into account when assessing the relationship to some critical values of the portal hepatic gradient.
目前,肝静脉插管术以及利用肝门静脉压力梯度(HVPG)值评估门静脉高压是一种首选方法。
在我们的论文中,我们将在5组肝硬化患者中比较HVPG与所谓的直接梯度——利用门静脉和游离肝静脉的压力差。
肝静脉插管术对于评估酒精性病因肝硬化患者组的门静脉高压是可靠的。在由乙型肝炎、威尔逊氏病或原发性胆汁性肝硬化导致的肝硬化患者中,已发现HVPG与直接梯度之间存在统计学上的显著差异。在丙型肝炎导致的肝硬化患者中,所获得的值有所不同,但无统计学意义。
在肝静脉插管术中,存在窦性前成分的肝硬化患者的HVPG值可能会降低,在评估与肝门静脉梯度某些临界值的关系时,这一点必须首先予以考虑。