Ueno S, Tanabe G, Sueyoshi K, Yoshinaka H, Yamamoto S, Kurita K, Yoshidome S, Nuruki K, Aikou T
First Department of Surgery, Kagoshima University School of Medicine, Japan.
Am J Gastroenterol. 1996 May;91(5):1012-5.
Nodular regenerative hyperplasia of the liver is an uncommon condition. Approximately 50% of these patients develop portal hypertension. Few previous reports document the site of increased resistance to blood flow within the liver in this disorder. We measured Doppler waveform patterns of the right hepatic vein by pulsed Doppler ultrasonography and portal, wedged hepatic, and free hepatic venous pressure by intravenous catheter before and after splenectomy in a 47-yr-old woman with nodular regenerative hyperplasia who presented with portal hypertension and pancytopenia. Nodular regenerative hyperplasia was histologically confirmed. Pre- and postoperative measures indicated a marked difference between wedged hepatic venous pressure and free hepatic venous pressure, whereas there was little difference between portal venous pressure and wedged hepatic venous pressure. Doppler waveform patterns of the right hepatic vein showed an unclear pulsatile flow pattern with a decreasing reversed phase. The above data suggest that portal hypertension in nodular regenerative hyperplasia is primarily sinusoidal, similar to that seen with cirrhosis.
肝脏结节性再生性增生是一种罕见病症。这些患者中约50%会发生门静脉高压。此前很少有报告记录该病症中肝脏内血流阻力增加的部位。我们对一名47岁患有结节性再生性增生并伴有门静脉高压和全血细胞减少症的女性患者，在脾切除术前和术后，通过脉冲多普勒超声测量了右肝静脉的多普勒波形图，并通过静脉导管测量了门静脉、肝楔压静脉和游离肝静脉压力。结节性再生性增生经组织学证实。术前和术后测量结果表明，肝楔压静脉压和游离肝静脉压之间存在显著差异，而门静脉压和肝楔压静脉压之间差异不大。右肝静脉的多普勒波形图显示搏动性血流模式不清晰，反向期缩短。上述数据表明，结节性再生性增生中的门静脉高压主要是窦性的，与肝硬化所见相似。
