Milani A, Ciammella A M, Rossi L
Istituto di Patologia Medica Università Cattolica del Sacro Cuore, Rome.
Z Gastroenterol. 1994 Jul;32(7):393-5.
The values of the intraabdominal pressure (IAP) were determined in 23 subjects with decompensated cirrhosis, both in basal conditions and after diuretic treatment (furosemide 75 mg/day orally for one week). In order to investigate the role of IAP in the regulation of ascites turn-over, ascites volume and free-water peritoneal clearance (FWPC) were estimated in the same patients by means of a methylene-blue dilution method. In wash-out conditions, no linear correlation was found between IAP and the values of ascites volume or FWPC. After diuretic treatment, we observed a significant reduction of ascites volumes (from 9.0 +/- 0.98 to 4.9 +/- 0.6 litres; p < 0.0005), IAP (from 17.5 +/- 1.3 to 11.3 +/- 0.8 cmH2O; p < 0.0005) and FWPC (from 99.8 +/- 6.7 to 76.2 +/- 6.6 ml/min; p < 0.001). In this situation, IAP values showed a significant linear correlation both with ascites volumes and clearances. These results may be due to the different weight of the two components of total IAP (hydrostatic pressure and abdominal tension): in the untreated patients (with larger ascites volumes) a considerable amount of the total IAP originates from the abdominal tension, and the correlation between IAP and ascites volumes or turn-over is biased. In the treated subjects (with lower ascites volumes) the tension component is minimal, and the correlation is resumed.
对23例失代偿期肝硬化患者测定了腹内压（IAP），分别在基础状态下以及利尿治疗后（口服呋塞米75mg/天，共1周）进行测定。为了研究IAP在腹水周转调节中的作用，通过亚甲蓝稀释法对同一批患者的腹水量和游离水腹腔清除率（FWPC）进行了评估。在清除期，未发现IAP与腹水量或FWPC值之间存在线性相关性。利尿治疗后，我们观察到腹水量（从9.0±0.98降至4.9±0.6升；p<0.0005）、IAP（从17.5±1.3降至11.3±0.8cmH2O；p<0.0005）和FWPC（从99.8±6.7降至76.2±6.6ml/min；p<0.001）均显著降低。在这种情况下，IAP值与腹水量和清除率均呈现显著的线性相关性。这些结果可能是由于总IAP的两个组成部分（静水压力和腹内张力）的权重不同：在未治疗的患者中（腹水量较大），总IAP的相当一部分来自腹内张力，IAP与腹水量或周转之间的相关性存在偏差。在接受治疗的患者中（腹水量较低），张力成分最小，相关性得以恢复。
