Yang S S, Wu C H, Chen T K, Lee C L, Lai Y C, Chen D S
Division of Gastroenterology, Cathay General Hospital, Taipei, Taiwan.
J Gastroenterol Hepatol. 1995 Jan-Feb;10(1):36-41. doi: 10.1111/j.1440-1746.1995.tb01044.x.
To evaluate the role of portal blood flow in severe acute hepatitis leading to the formation of ascites, we studied the portal blood flow of 30 patients with severe acute hepatitis (20 without ascites and 10 with ascites), 20 patients with mild acute hepatitis and 20 healthy normal volunteers using duplex sonography. The portal blood flow of patients with severe acute hepatitis and ascites (421 +/- 94 mL/min) was lower than that of the volunteers (725 +/- 131 mL/min), the mild acute hepatitis (658 +/- 148 mL/min), and the severe acute hepatitis (633 +/- 108mL/min) without ascites (P < 0.001). The congestion index of severe acute hepatitis and ascites (0.16 +/- 0.04 cm.s) was higher than that of the volunteers (0.09 +/- 0.03 cm.s, P < 0.001), the mild acute hepatitis (0.09 +/- 0.02 cm.s, P < 0.001), and the severe acute hepatitis (0.12 +/- 0.04 cm.s, P < 0.02) without ascites. Portal blood flow was negatively correlated with prolonged prothrombin time (P < 0.001) and serum total bilirubin level (P = 0.002) and congestion index was positively correlated with heart rate (P = 0.006), prolonged prothrombin time (P < 0.001) and serum total bilirubin level (P = 0.001). Our study shows that in severe acute hepatitis, portal blood flow was reduced in patients with ascites. The non-invasive ultrasonic Doppler is a safe and helpful method in the clinical evaluation of portal hypertension in severe acute hepatitis.
为评估门静脉血流在导致腹水形成的严重急性肝炎中的作用，我们使用双功超声检查研究了30例严重急性肝炎患者（20例无腹水，10例有腹水）、20例轻度急性肝炎患者和20名健康正常志愿者的门静脉血流。伴有腹水的严重急性肝炎患者的门静脉血流（421±94毫升/分钟）低于志愿者（725±131毫升/分钟）、轻度急性肝炎患者（658±148毫升/分钟）以及无腹水的严重急性肝炎患者（633±108毫升/分钟）（P<0.001）。伴有腹水的严重急性肝炎患者的充血指数（0.16±0.04厘米·秒）高于志愿者（0.09±0.03厘米·秒，P<0.001）、轻度急性肝炎患者（0.09±0.02厘米·秒，P<0.001）以及无腹水的严重急性肝炎患者（0.12±0.04厘米·秒，P<0.02）。门静脉血流与凝血酶原时间延长（P<0.001）和血清总胆红素水平（P=0.002）呈负相关，充血指数与心率（P=0.006）、凝血酶原时间延长（P<0.001）和血清总胆红素水平（P=0.001）呈正相关。我们的研究表明，在严重急性肝炎中，有腹水患者的门静脉血流减少。无创超声多普勒是临床评估严重急性肝炎门静脉高压的一种安全且有用的方法。
