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孟加拉国肝硬化患者肝静脉压力梯度测量:与Child分级、静脉曲张大小及出血的相关性

Hepatic Venous Pressure Gradient Measurement in Bangladeshi Cirrhotic Patients: A Correlation with Child's Status, Variceal Size, and Bleeding.

作者信息

Al Mahtab Mamun, M Noor E Alam Sheikh, A Rahim Mohammad, A Alam Mohammad, A Khondaker Faiz, L Moben Ahmed, Mohsena Masuda, Mohammad Fazle Akbar Sheikh

机构信息

Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka, Bangladesh.

Department of Hepatology Abdul Malek Ukil Medical College, Noakhali, Bangladesh.

出版信息

Euroasian J Hepatogastroenterol. 2017 Jul-Dec;7(2):142-145. doi: 10.5005/jp-journals-10018-1235. Epub 2017 Sep 29.

Abstract

BACKGROUND

Hepatic venous pressure gradient (HVPG) reflects the portal pressure in patients with cirrhotic portal hypertension. The aim of the study was to assess the relation of HVPG to variceal size, Child-Pugh status, and variceal bleeding.

MATERIALS AND METHODS

A total of 96 patients with cirrhosis of liver were enrolled prospectively and each patient's HVPG level was measured via the transfemoral route. Clinical and biochemical evaluation and upper gastrointestinal (GI) endoscopy were done in each subject. Severity of cirrhosis was assessed by Child's status.

RESULTS

The mean HVPG was higher in patients with Child's B and C (14.10 ± 7.56 and 13.64 ± 7.17 mm Hg respectively) compared with those of Child's A (10.15 ± 5.63 mm Hg). The levels of HVPG differed significantly between Child's classes A and B (p = 0.011) and Child's A and C (p = 0.041). The mean HVPG was also higher in bleeders compared with nonbleeders with large varices (17.7 ± 5.5 14.9 ± 4.7 mmHg respectively; p = 0.006).

CONCLUSION

Hepatic venous pressure gradient seems to be important to assess the severity of liver cirrhosis. Al Mahtab M, Noor E Alam SM, Rahim MA, Alam MA, Khondaker FA, Moben AL, Mohsena M, Akbar SMF. Hepatic Venous Pressure Gradient Measurement in Bangladeshi Cirrhotic Patients: A Correlation with Child's Status, Variceal Size, and Bleeding. Euroasian J Hepato-Gastroenterol 2017;7(2):142-145.

摘要

背景

肝静脉压力梯度(HVPG)反映肝硬化门静脉高压患者的门静脉压力。本研究旨在评估HVPG与静脉曲张大小、Child-Pugh分级以及静脉曲张出血之间的关系。

材料与方法

前瞻性纳入96例肝硬化患者,通过经股途径测量每位患者的HVPG水平。对每位受试者进行临床和生化评估以及上消化道(GI)内镜检查。根据Child分级评估肝硬化的严重程度。

结果

与Child A级患者(10.15±5.63 mmHg)相比,Child B级和C级患者的平均HVPG更高(分别为14.10±7.56和13.64±7.17 mmHg)。Child A级与B级(p = 0.011)以及Child A级与C级(p = 0.041)之间的HVPG水平差异有统计学意义。与有大静脉曲张的非出血患者相比,出血患者的平均HVPG也更高(分别为17.7±5.5和14.9±4.7 mmHg;p = 0.006)。

结论

肝静脉压力梯度似乎对评估肝硬化的严重程度很重要。Al Mahtab M,Noor E Alam SM,Rahim MA,Alam MA,Khondaker FA,Moben AL,Mohsena M,Akbar SMF。孟加拉国肝硬化患者肝静脉压力梯度测量:与Child分级、静脉曲张大小和出血的相关性。《欧亚肝脏胃肠病学杂志》2017;7(2):142 - 145。

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