Cereda J M, Braillon A, Ozier Y, Moreau R, Gaudin C, Lebrec D
Unité de Recherches de Physiopathologie Hépatique, INSERM U 24, Hôpital Beaujon, Clichy.
Gastroenterol Clin Biol. 1989 May;13(5):495-8.
The effect of ascites on splanchnic and systemic hemodynamics was retrospectively studied in 256 patients with alcoholic cirrhosis. The patients were divided into 3 classes: no ascites, moderate ascites, and large ascites. They were also classed into 3 groups according to a modified Pugh classification (ascites was not taken into account). In patients without ascites, cardiac output was positively related to the severity of liver disease. This result was not found in patients with large ascites. Similarly, in patients with no or moderate ascites, the degree of portal hypertension estimated by the hepatic venous pressure gradient was associated with liver failure. In patients with large ascites, hepatic venous pressure gradient was higher than in patients without ascites but this relation was observed only in patients without liver failure. These results show that ascites reduces the relation between cardiac output and liver failure and increases the degree of portal hypertension but not cardiac output.
对256例酒精性肝硬化患者腹水对内脏和全身血流动力学的影响进行了回顾性研究。患者分为3类:无腹水、中度腹水和大量腹水。他们还根据改良的Pugh分类法分为3组(未考虑腹水情况)。在无腹水的患者中,心输出量与肝病严重程度呈正相关。大量腹水患者未发现此结果。同样,在无腹水或中度腹水的患者中,通过肝静脉压力梯度估计的门静脉高压程度与肝衰竭相关。在大量腹水患者中,肝静脉压力梯度高于无腹水患者,但这种关系仅在无肝衰竭的患者中观察到。这些结果表明,腹水减弱了心输出量与肝衰竭之间的关系,增加了门静脉高压程度,但未增加心输出量。