Siringo S, Bolondi L, Gaiani S, Sofia S, Di Febo G, Zironi G, Rigamonti A, Miglioli M, Cavalli G, Barbara L
Istituto di Clinica Medica e Gastroenterologia, Università di Bologna, Italy.
J Hepatol. 1994 Jan;20(1):11-8. doi: 10.1016/s0168-8278(05)80461-1.
The relationship of the endoscopic aspect of esophageal varices, portal quantitative Doppler ultrasound parameters and clinical and biochemical findings was assessed in 149 patients with cirrhosis stratified according to the presence of esophageal varices (n = 115) and the absence of previous bleeding (n = 96). In this series of patients the presence of esophageal varices and red signs proved to be significantly correlated with the severity of cirrhosis. However, in the group of patients with varices, no correlation was found between variceal size and the degree of liver failure. Portal blood flow velocity was significantly different in the endoscopic subgroups, but not in the clinical and biochemical subgroups. Furthermore, portal blood flow velocity was found to correlate only with the presence and size of esophageal varices. The Congestion Index of the portal vein (derived from the ratio between the cross-sectional area of the portal vein and the mean velocity of portal flow) was significantly different in most clinical, biochemical and endoscopic subgroups and was correlated with liver function, presence and size of varices, and presence and degree of red signs. We conclude that the Congestion Index of the portal vein, the clinical status and the endoscopic aspect of varices are not independent features in patients with cirrhosis. As for liver function and endoscopic findings, portal Doppler ultrasound parameters, in particular the Congestion Index, may contribute to a better clinical assessment in patients with cirrhosis.
在149例肝硬化患者中，根据食管静脉曲张的有无（n = 115）和既往有无出血（n = 96）进行分层，评估食管静脉曲张的内镜表现、门静脉定量多普勒超声参数与临床及生化检查结果之间的关系。在这组患者中，食管静脉曲张和红色征的存在与肝硬化的严重程度显著相关。然而，在有静脉曲张的患者组中，未发现静脉曲张大小与肝功能衰竭程度之间存在相关性。门静脉血流速度在内镜亚组中有显著差异，但在临床和生化亚组中无显著差异。此外，发现门静脉血流速度仅与食管静脉曲张的存在及大小相关。门静脉充血指数（由门静脉横截面积与门静脉平均流速之比得出）在大多数临床、生化和内镜亚组中均有显著差异，且与肝功能、静脉曲张的存在及大小以及红色征的存在及程度相关。我们得出结论，门静脉充血指数、临床状况和静脉曲张的内镜表现并非肝硬化患者的独立特征。至于肝功能和内镜检查结果，门静脉多普勒超声参数，尤其是充血指数，可能有助于对肝硬化患者进行更好的临床评估。
