Meng H C, Lin H C, Tsai Y T, Lee F Y, Liao D M, Hsia H C, Lin W J, Chang T T, Lay C S, Wang S S
Department of Medicine, Taipei Veterans General Hospital, Taiwan, Republic of China.
J Gastroenterol Hepatol. 1994 Mar-Apr;9(2):148-53. doi: 10.1111/j.1440-1746.1994.tb01235.x.
The relationship between the severity of cirrhosis and systemic and hepatic haemodynamic values was evaluated in 193 patients with cirrhosis, most of whom were diagnosed with post-necrotic cirrhosis. It was found that the hepatic venous pressure gradient and cardiac output in Pugh's A patients (13.6 +/- 4.8 mmHg and 6.2 +/- 1.6 L/min, mean +/- s.d.) were significantly lower than in both Pugh's B (16.8 +/- 4.3 mmHg and 7.3 +/- 2.1 L/min) and Pugh's C (18.8 +/- 5.5 mmHg and 7.4 +/- 2.3 L/min) patients (P < 0.01), respectively. In contrast, the systemic vascular resistance in Pugh's A patients (1232 +/- 369 dyn/s per cm5) was significantly higher than in both Pugh's B (1016 +/- 345 dyn/s per cm5) and Pugh's C (935 +/- 234 dyn/s per cm5) patients (P < 0.01), respectively. Additionally, not only was there a positive correlation found between Pugh's score and cardiac output and hepatic venous pressure gradient, but a negative correlation was found between Pugh's score and systemic vascular resistance. It was also confirmed that the degree of portal hypertension and the hyperdynamic circulation were more severe in patients with ascites than in those without ascites. However, there were no statistically significant differences in hepatic venous pressure gradient among patients with F1, F2 and F3 esophageal varices (15.7 +/- 4.0, 17.0 +/- 4.8 and 18.0 +/- 4.8 mmHg, respectively). It is concluded that in those patients with cirrhosis, the severity of cirrhosis is closely related to the degree of the hyperkinetic circulatory state and portal hypertension.
对193例肝硬化患者的肝硬化严重程度与全身及肝脏血流动力学值之间的关系进行了评估，其中大多数患者被诊断为坏死后肝硬化。结果发现，Pugh A级患者的肝静脉压力梯度和心输出量（分别为13.6±4.8 mmHg和6.2±1.6 L/min，均值±标准差）显著低于Pugh B级患者（16.8±4.3 mmHg和7.3±2.1 L/min）和Pugh C级患者（18.8±5.5 mmHg和7.4±2.3 L/min）（P<0.01）。相反，Pugh A级患者的全身血管阻力（1232±369 dyn/s·cm⁻⁵）显著高于Pugh B级患者（1016±345 dyn/s·cm⁻⁵）和Pugh C级患者（935±234 dyn/s·cm⁻⁵）（P<0.01）。此外，不仅发现Pugh评分与心输出量和肝静脉压力梯度呈正相关，而且发现Pugh评分与全身血管阻力呈负相关。还证实，腹水患者的门静脉高压程度和高动力循环比无腹水患者更严重。然而，F1、F2和F3级食管静脉曲张患者的肝静脉压力梯度无统计学显著差异（分别为15.7±4.0、17.0±4.8和18.0±4.8 mmHg）。结论是，在那些肝硬化患者中，肝硬化的严重程度与高动力循环状态和门静脉高压程度密切相关。
