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健康受试者和肝硬化患者摄入葡萄糖后肝动脉的血流动力学变化。

Hemodynamic changes in hepatic artery after glucose ingestion in healthy subjects and patients with cirrhosis.

作者信息

Numata K, Tanaka K, Kiba T, Mitsui K, Saito S, Sekihara H

机构信息

Third Department of Internal Medicine, Yokohama City University School of Medicine, Japan.

出版信息

J Clin Ultrasound. 1998 Mar-Apr;26(3):137-42. doi: 10.1002/(sici)1097-0096(199803/04)26:3<137::aid-jcu5>3.0.co;2-n.

Abstract

PURPOSE

The purpose of this study was to investigate hemodynamic changes in the hepatic artery after glucose ingestion.

METHODS

We used color Doppler sonography to measure hemodynamic changes in the right hepatic artery and the right portal vein in response to glucose ingestion (225 ml, 300 kcal) in 25 healthy subjects and 25 patients with cirrhosis.

RESULTS

In healthy subjects, the peak systolic and end-diastolic velocities in the right hepatic artery decreased (33 +/- 3% and 53 +/- 3%) from baseline velocities measured in the fasting state. The resistance index of the right hepatic artery and the velocity in the right portal vein in these subjects significantly (p < 0.01) increased (14 +/- 2% and 32 +/- 2%) from baseline values after glucose ingestion. Glucose ingestion produced significantly (p < 0.01) smaller changes in cirrhotic patients. The maximum decrease in the peak systolic and end-diastolic velocities in the right hepatic artery were 13 +/- 2% and 25 +/- 3% from baseline velocities, and the maximum increases in the resistance index of the right hepatic artery and the velocity in the right portal vein were 6 +/- 1% and 10 +/- 3% from baseline values.

CONCLUSIONS

The decrease in blood flow velocity in the right hepatic artery after glucose ingestion is presumably a homeostatic mechanism to maintain constant hepatic perfusion. This reciprocal response was reduced in cirrhotic patients.

摘要

目的

本研究旨在探讨摄入葡萄糖后肝动脉的血流动力学变化。

方法

我们使用彩色多普勒超声测量25名健康受试者和25名肝硬化患者摄入葡萄糖(225毫升,300千卡)后右肝动脉和右门静脉的血流动力学变化。

结果

在健康受试者中,右肝动脉的收缩期峰值速度和舒张末期速度较空腹状态下测量的基线速度降低(分别为33±3%和53±3%)。这些受试者右肝动脉的阻力指数和右门静脉的血流速度在摄入葡萄糖后较基线值显著(p<0.01)增加(分别为14±2%和32±2%)。摄入葡萄糖后,肝硬化患者的变化显著(p<0.01)较小。右肝动脉收缩期峰值速度和舒张末期速度较基线速度的最大降幅分别为13±2%和25±3%,右肝动脉阻力指数和右门静脉血流速度较基线值的最大增幅分别为6±1%和10±3%。

结论

摄入葡萄糖后右肝动脉血流速度降低可能是维持肝脏恒定灌注的一种稳态机制。肝硬化患者的这种相互反应减弱。

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