Ohnishi K, Chin N, Sugita S, Saito M, Tanaka H, Terabayashi H, Saito M, Iida S, Nomura F, Okuda K
Gastroenterology. 1987 Jul;93(1):129-34. doi: 10.1016/0016-5085(87)90324-6.
To estimate vascular changes in chronic liver disease, we quantitated intrahepatic arteriovenous and portal-systemic shunts in 12 patients with cirrhosis and arteriovenous shunts alone in 4 patients with cirrhosis. An index was obtained for intrahepatic arteriovenous shunts by instilling technetium 99m-macroaggregated albumin into the proper hepatic artery and portal-systemic shunts, by the same procedure done in the portal trunk, near the porta hepatis on different days. Counts were taken over the liver and both lungs in the anterior as well as the posterior view for calculation of the shunt index: cpm in lungs divided by cpm in liver and lungs X 100%. In the 12 patients with cirrhosis in whom both shunts were measured, intrahepatic arteriovenous shunting was significantly lower compared with intrahepatic portal-systemic shunting (1.4% +/- 1.1% vs. 36.0% +/- 29.0%, p less than 0.001). Thus, it seems that in patients with cirrhosis, the development of intrahepatic arteriovenous shunts is not as great as that of portal-systemic shunts, which were found in this study to be considerable and variable in degree.
为评估慢性肝病中的血管变化，我们对12例肝硬化患者的肝内动静脉分流和门体分流进行了定量分析，对4例肝硬化患者单独进行了动静脉分流定量分析。通过将锝99m - 大颗粒白蛋白注入肝固有动脉来获得肝内动静脉分流指数，通过在不同日期于肝门附近的门静脉主干进行相同操作来获得门体分流指数。在前位和后位对肝脏和双肺进行计数，以计算分流指数：肺内每分钟计数除以肝脏和肺内每分钟计数×100%。在测量了两种分流的12例肝硬化患者中，肝内动静脉分流与肝内门体分流相比显著更低（1.4%±1.1%对36.0%±29.0%，p<0.001）。因此，在肝硬化患者中，肝内动静脉分流的发展似乎不如门体分流，本研究发现门体分流程度相当且存在差异。
