Celebi H, Dönder E, Celiker H
Department of Internal Medicine, Firat University School of Medicine, Elaziğ, Turkey.
Arch Intern Med. 1997 Mar 10;157(5):564-6. doi: 10.1001/archinte.157.5.564.
Hepatorenal syndrome, a well-recognized complication of established liver disease, is characterized by early renal vasoconstriction before clinically recognized renal disease. Renal vasoconstriction causes increased renal vascular resistance, which can be detected noninvasively by Doppler ultrasonography.
To detect early renal hemodynamic changes in patients with hepatic cirrhosis who had clinically normal renal functions.
Twenty patients with hepatic cirrhosis and ascites, 11 patients with hepatic cirrhosis without ascites, and 23 healthy control subjects. All cirrhotic patients had normal serum urea nitrogen and creatinine values.
Peak systolic, peak diastolic, and mean flow velocities; pulsatile index; resistive index; and peak systolic velocity/peak diastolic velocity ratio as measured by renal Doppler ultrasonography.
Peak diastolic flow velocity was significantly lower in cirrhotic patients with ascites than in cirrhotic patients without ascites and control subjects (P < .02 and P < .004, respectively), but the peak systolic flow velocity/peak diastolic flow velocity ratio (P < .007 and P < .001, respectively), pulsatile index (P < .007 and P < .001, respectively), and resistive index (P < .007 and P < .001, respectively) were significantly higher in cirrhotic patients with ascites than in cirrhotic patients without ascites and controls.
Renal Doppler ultrasonography can noninvasively identify a subgroup of nonazotemic patients with hepatic cirrhosis who are at high risk for subsequent development of renal dysfunction and hepatorenal syndrome.
肝肾综合征是一种公认的终末期肝病并发症，其特征是在临床上确诊肾病之前出现早期肾血管收缩。肾血管收缩导致肾血管阻力增加，这可以通过多普勒超声进行无创检测。
检测肝功能正常的肝硬化患者早期的肾脏血流动力学变化。
20例肝硬化腹水患者、11例肝硬化无腹水患者以及23名健康对照者。所有肝硬化患者的血清尿素氮和肌酐值均正常。
通过肾脏多普勒超声测量的收缩期峰值流速、舒张期峰值流速、平均流速、搏动指数、阻力指数以及收缩期峰值流速/舒张期峰值流速比值。
肝硬化腹水患者的舒张期峰值流速显著低于肝硬化无腹水患者及健康对照者（分别为P < 0.02和P < 0.004），但肝硬化腹水患者的收缩期峰值流速/舒张期峰值流速比值（分别为P < 0.007和P < 0.001）、搏动指数（分别为P < 0.007和P < 0.001）以及阻力指数（分别为P < 0.007和P < 0.001）显著高于肝硬化无腹水患者及健康对照者。
肾脏多普勒超声可无创识别一组非氮质血症肝硬化患者，这些患者随后发生肾功能不全和肝肾综合征的风险较高。
