Garcia-Tsao G, Groszmann R J, Fisher R L, Conn H O, Atterbury C E, Glickman M
Hepatology. 1985 May-Jun;5(3):419-24. doi: 10.1002/hep.1840050313.
This study was performed to examine the relationships between portal pressure measurements and the presence of esophagogastric varices, the size of varices and the occurrence of hemorrhage from varices in 93 patients with alcoholic cirrhosis, using standardized measurements of portal pressure by hepatic vein catheterization. The mean hepatic vein pressure gradient (HVPG) was significantly higher in 49 patients who had bled from varices than in 44 cirrhotic patients who had not (20.4 +/- 5.1 vs. 16.0 +/- 5.2; p less than 0.001). None of the 49 patients who had bled from varices had an HVPG less than 12 mm Hg. Among the 87 patients who had been examined by endoscopy for varices, all 72 with varices had an HVPG greater than 12 mm Hg. Six of 15 cirrhotic patients without varices had HVPG less than 12 mm Hg. The mean HVPG in the 15 patients without varices (15.1 +/- 6.8 mm Hg) was lower than the 72 patients with varices (19.3 +/- 4.8 mm Hg; p less than 0.01). Of the 72 patients with varices, 40 had large varices, 28 had small varices, and in four patients variceal size could not be assessed adequately. The mean HVPG was similar in the patients with large or small varices (19.8 +/- 4.8 vs. 18.3 +/- 5.0 mm Hg; p greater than 0.10). There was a positive relationship between the presence of large varices and the occurrence of bleeding from varices.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究旨在通过肝静脉插管对门静脉压力进行标准化测量，以探讨93例酒精性肝硬化患者门静脉压力测量值与食管胃静脉曲张的存在、静脉曲张大小及静脉曲张出血发生率之间的关系。49例静脉曲张出血患者的平均肝静脉压力梯度（HVPG）显著高于44例未出血的肝硬化患者（20.4±5.1 vs. 16.0±5.2；p<0.001）。49例静脉曲张出血患者中，无一例HVPG低于12 mmHg。在87例接受内镜检查以评估静脉曲张的患者中，所有72例有静脉曲张的患者HVPG均大于12 mmHg。15例无静脉曲张的肝硬化患者中有6例HVPG低于12 mmHg。15例无静脉曲张患者的平均HVPG（15.±6.8 mmHg）低于72例有静脉曲张的患者（19.3±4.8 mmHg；p<0.01）。72例有静脉曲张的患者中，40例为大静脉曲张，28例为小静脉曲张，4例患者的静脉曲张大小无法充分评估。大静脉曲张和小静脉曲张患者的平均HVPG相似（19.8±4.8 vs. 18.3±5.0 mmHg；p>0.10）。大静脉曲张的存在与静脉曲张出血的发生之间存在正相关关系。（摘要截断于250字）
