Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea.
Clin Mol Hepatol. 2014 Mar;20(1):6-14. doi: 10.3350/cmh.2014.20.1.6. Epub 2014 Mar 26.
Portal hypertension is a severe consequence of chronic liver diseases and is responsible for the main clinical complications of liver cirrhosis. Hepatic venous pressure gradient (HVPG) measurement is the best available method to evaluate the presence and severity of portal hypertension. Clinically significant portal hypertension is defined as an increase in HVPG to >10 mmHg. In this condition, the complications of portal hypertension might begin to appear. HVPG measurement is increasingly used in the clinical fields, and the HVPG is a robust surrogate marker in many clinical applications such as diagnosis, risk stratification, identification of patients with hepatocellular carcinoma who are candidates for liver resection, monitoring of the efficacy of medical treatment, and assessment of progression of portal hypertension. Patients who had a reduction in HVPG of ≥ 20% or to ≤ 12 mmHg in response to drug therapy are defined as responders. Responders have a markedly decreased risk of bleeding/rebleeding, ascites, and spontaneous bacterial peritonitis, which results in improved survival. This review provides clinical use of HVPG measurement in the field of liver disease.
门静脉高压症是慢性肝病的严重后果，是肝硬化的主要临床并发症的原因。肝静脉压力梯度（HVPG）测量是评估门静脉高压症存在和严重程度的最佳方法。临床上显著的门静脉高压症定义为 HVPG 增加至>10mmHg。在这种情况下，门静脉高压症的并发症可能开始出现。HVPG 测量在临床领域中越来越多地被使用，HVPG 在许多临床应用中是一个强有力的替代标志物，如诊断、风险分层、确定适合肝切除术的肝细胞癌患者、监测药物治疗的疗效以及评估门静脉高压症的进展。对药物治疗有反应的患者定义为 HVPG 降低≥20%或降至≤12mmHg 的患者。有反应的患者出血/再出血、腹水和自发性细菌性腹膜炎的风险明显降低，从而提高了生存率。这篇综述提供了 HVPG 测量在肝病领域的临床应用。
