Merkel C, Gatta A, Arnaboldi L, Zuin R
Clin Physiol. 1985 Dec;5(6):531-9. doi: 10.1111/j.1475-097x.1985.tb00766.x.
The relationships between portal hypertension and spleen enlargement, in patients with liver cirrhosis, are not clearly defined; as well as those between splenic haemodynamics and portal hypertension. In 25 cirrhotics with spleen enlargement and portal hypertension and in seven controls, the following parameters were determined: estimated splenic volume (ESV) from the radiographic view of the spleen, according to Blendis, Williams and Kreel (1969), specific splenic blood-flow (SSBF), total splenic blood-flow (TSBF), porto-hepatic gradient (PHG), specific splenic resistance (SSR) and total splenic resistance (TSR). Moreover, the size and extension of oesophageal varices, at oesophagoscopy, were classified according to Dagradi (1973). PHG, ESV and TSBF were increased in all subjects, SSBF was increased in two cases, SSR was increased in two cases and decreased in two cases, TSR was decreased in all cases and ESV was not correlated to the level of portal hypertension. Neither TSBF nor TSR were found to be correlated to the level of portal hypertension, as estimated by PHG or by oesophageal varices. It is concluded that, in patients with liver cirrhosis and spleen enlargement, splenomegaly is likely to be the consequence of pulp hyperplasia and not of passive congestion, and that increases in splenic blood-flow do not contribute significantly to portal hypertension.
肝硬化患者门静脉高压与脾肿大之间的关系尚未明确界定；脾血流动力学与门静脉高压之间的关系也不明确。对25例伴有脾肿大和门静脉高压的肝硬化患者以及7例对照者测定了以下参数：根据Blendis、Williams和Kreel（1969年）的方法，通过脾脏X线影像估算脾体积（ESV）、脾比血流量（SSBF）、脾总血流量（TSBF）、肝门脉梯度（PHG）、脾比阻力（SSR）和脾总阻力（TSR）。此外，根据Dagradi（1973年）的方法，在食管镜检查时对食管静脉曲张的大小和范围进行分类。所有受试者的PHG、ESV和TSBF均升高，2例患者的SSBF升高，2例患者的SSR升高，2例患者的SSR降低，所有患者的TSR均降低，且ESV与门静脉高压水平无关。未发现TSBF和TSR与通过PHG或食管静脉曲张评估的门静脉高压水平相关。结论是，在伴有脾肿大的肝硬化患者中，脾肿大可能是脾髓增生的结果而非被动性充血的结果，且脾血流增加对门静脉高压的影响不显著。
