Zjačić Puljiz Danijela, Delić Jukić Ivana Kristina, Puljiz Marko, Vicelić Čutura Lučana, Jerčić Martinić-Ceza Iva, Božić Dorotea, Podrug Kristian, Puljiz Željko
Danijela Zjačić Puljiz, Spinčićeva 1, 21000 Split, Croatia,
Croat Med J. 2021 Feb 28;62(1):34-43. doi: 10.3325/cmj.2021.62.34.
To evaluate liver stiffness (LS) by real-time two-dimensional shear wave elastography (RT 2D-SWE) and to assess its correlation with the mean arterial pressure (MAP) in patients on maintenance hemodialysis (MHD). The secondary aim was to identify biological and biochemical parameters associated with elevated LS.
This study enrolled patients treated with MHD in the Split University Hospital from December 2017 through February 2018. LS was measured after a HD session using RT 2D-SWE. Mean arterial pressure was measured before RT-2D-SWE was performed.
The study enrolled 47 patients with the mean±standard deviation age of 68.48±14.33 years. Arterial hypertension was diagnosed in 70.2% of patients. Liver stiffness >7 kPa, suggesting clinically relevant fibrosis, was found in 59.5% of patients. Arterial pressure was significantly correlated with LS (ρ=0.38, P=0.008). C-reactive protein (ρ=0.548, P=0.023), parathyroid hormone (ρ=0.507, P=0.038), and total bilirubin (ρ=0.423, P=0.020) were correlated with elevated LS.
Mean arterial pressure is correlated with increased LS in patients on MHD. Our results emphasize the importance of proper regulation of arterial blood pressure and indicate that LS should always be interpreted in combination with laboratory parameters. Further prospective studies with larger series are needed.
通过实时二维剪切波弹性成像（RT 2D-SWE）评估维持性血液透析（MHD）患者的肝脏硬度（LS），并评估其与平均动脉压（MAP）的相关性。次要目的是确定与LS升高相关的生物学和生化参数。
本研究纳入了2017年12月至2018年2月在斯普利特大学医院接受MHD治疗的患者。在一次血液透析治疗后使用RT 2D-SWE测量LS。在进行RT-2D-SWE之前测量平均动脉压。
该研究纳入了47例患者，平均年龄±标准差为68.48±14.33岁。70.2%的患者被诊断为动脉高血压。59.5%的患者肝脏硬度>7 kPa，提示存在临床相关纤维化。动脉压与LS显著相关（ρ=0.38，P=0.008）。C反应蛋白（ρ=0.548，P=0.023）、甲状旁腺激素（ρ=0.507，P=0.038）和总胆红素（ρ=0.423，P=0.020）与LS升高相关。
MHD患者的平均动脉压与LS升高相关。我们的结果强调了适当调节动脉血压的重要性，并表明应始终结合实验室参数来解释LS。需要进一步进行更大样本量的前瞻性研究。
