Klein C P, Kalk J F, Müting D, Klein C G
Department Innere Medizin-Gastroenterologie, Heinz-Kalk-Krankenhaus, Bad Kissingen.
Dtsch Med Wochenschr. 1993 Jan 29;118(4):89-93. doi: 10.1055/s-2008-1059304.
The influence of alcohol on portal vein haemodynamics was assessed prospectively in 30 patients (20 men, 10 women; mean age 54.3 [34-70] years) with nutritional-toxic cirrhosis of the liver (Child-Pugh stages A-C) and portal vein hypertension. During the period of observation hepatic vein occlusion pressure as an indirect measure of portal vein pressure was repeatedly determined. In addition, the size of oesophageal varices and the Child-Pugh stage were monitored. After complete alcohol abstinence of one year, portal vein pressure fell from 23.11 to 12.43 mm Hg (-46%, P < 0.001), the Child-Pugh score from 8.08 to 7.2 (-10.9%, not significant), and the size of oesophageal varices was reduced from grade 1.33 to grade 0.79 (-40%, P < 0.02). On resuming alcohol abuse, portal vein pressure increased by an average of 10 mm Hg (+60%, P < 0.001) to its previous level of 25 mm Hg. The portal vein pressure has thus proved to be a sensitive gauge of alcohol abstinence or abuse. Lasting, absolute alcohol abstinence is essential in nutritional-toxic liver cirrhosis.
对30例患有营养 - 中毒性肝硬化（Child - Pugh分级A - C级）和门静脉高压症的患者（20名男性，10名女性；平均年龄54.3[34 - 70]岁）进行前瞻性研究，评估酒精对门静脉血流动力学的影响。在观察期间，反复测定肝静脉闭塞压作为门静脉压力的间接指标。此外，监测食管静脉曲张的大小和Child - Pugh分级。在完全戒酒一年后，门静脉压力从23.11毫米汞柱降至12.43毫米汞柱（-46%，P < 0.001），Child - Pugh评分从8.08降至7.2（-10.9%，无统计学意义），食管静脉曲张大小从1.33级降至0.79级（-40%，P < 0.02）。重新开始酗酒时，门静脉压力平均升高10毫米汞柱（+60%，P < 0.001），恢复到之前25毫米汞柱的水平。因此，门静脉压力已被证明是戒酒或酗酒的敏感指标。对于营养 - 中毒性肝硬化患者，持久、绝对戒酒至关重要。
