de Vries P J, Hoekstra J B, de Hooge P, van Hattum J
Dept. of Gastroenterology, University Hospital, Utrecht, The Netherlands.
Scand J Gastroenterol. 1994 Feb;29(2):172-7. doi: 10.3109/00365529409090458.
The evolution of portal venous flow in non-end-stage chronic liver disease with portal hypertension was assessed in 59 patients and compared with that in 55 control subjects and by means of duplex Doppler measurements by a single observer. All patients were prospectively followed up, and a repeated measurement was performed in a subgroup of 23 patients. The mean (+/- SD) portal venous diameter and velocity of patients versus controls were 11.2 (+/- 2.0) mm versus 10.1 (+/- 1.4) mm (p < 0.0005) and 11.0 (+/- 4.2) cm/sec versus 13.9 (+/- 4.1) cm/sec (p < 0.0005). The portal venous flow did not differ: 671 (+/- 291) ml/min versus 652 (+/- 203) ml/min. Diagnosis, Child class, and grade of varices did not influence the portal flow. Patients were followed up during a median (+/- SD) time of 47 (+/- 17) months. Nineteen (32%) patients died, and 14 (23%) had a variceal hemorrhage. Survival and hemorrhage were not correlated with the portal venous flow. Subsequent measurements in 23 patients showed a significant decrease in portal venous flow in 5 patients who died during follow-up. This was not found in the patients who survived. It is concluded that portal venous flow in chronic liver disease with portal hypertension is stable for a long time in the evolution of chronic liver disease. The existence of a 'portostat' is postulated. Only in the terminal stage of liver disease can a reduction of the portal venous flow be detected.
通过单名观察者采用双功多普勒测量法，对59例非终末期慢性肝病合并门静脉高压患者的门静脉血流演变情况进行了评估，并与55例对照者进行比较。所有患者均接受前瞻性随访，23例患者亚组进行了重复测量。患者与对照者的门静脉平均直径（±标准差）分别为11.2（±2.0）mm和10.1（±1.4）mm（p<0.0005），平均流速分别为11.0（±4.2）cm/秒和13.9（±4.1）cm/秒（p<0.0005）。门静脉血流量无差异：分别为671（±291）ml/分钟和652（±203）ml/分钟。诊断、Child分级及静脉曲张程度均不影响门静脉血流。患者随访时间中位数（±标准差）为47（±17）个月。19例（32%）患者死亡，14例（23%）发生静脉曲张出血。生存及出血情况与门静脉血流无关。23例患者的后续测量显示，随访期间死亡的5例患者门静脉血流显著减少。存活患者未发现此情况。结论是，在慢性肝病的演变过程中，门静脉高压的慢性肝病患者门静脉血流在很长时间内保持稳定。推测存在“门静脉调节器”。仅在肝病终末期才能检测到门静脉血流减少。
