晚期肝炎后肝硬化患者与健康成年人的门静脉和内脏血流动力学。经双功多普勒超声评估。

Portal and splanchnic haemodynamics in patients with advanced post-hepatitic cirrhosis and in healthy adults. Assessment with duplex Doppler ultrasound.

作者信息

Dinç H, Sari A, Resit Gümele H, Cihanyurdu N, Baki A

机构信息

Department of Radiology, KTU Medical Faculty, Trabzon, Turkey.

出版信息

Acta Radiol. 1998 Mar;39(2):152-6. doi: 10.1080/02841859809172169.

DOI:10.1080/02841859809172169

PMID:9529445

Abstract

PURPOSE

To assess portal and splanchnic haemodynamics, and splanchnic vascular resistance in patients with advanced post-hepatitic cirrhosis and in healthy volunteers, by means of duplex Doppler ultrasound (US).

MATERIAL AND METHODS

The duplex Doppler US examination was performed in 16 patients with cirrhosis and in 24 healthy volunteers. We investigated vessel diameters, mean flow velocities, and mean blood flows in the portal vein, the superior mesenteric artery (SMA), and the splenic artery (SA), and measured the resistive index values of SMA and SA.

RESULTS

The mean portal venous blood flow in patients with cirrhosis (829 +/- 264 ml/min) was not statistically different from those in the volunteers (734 +/- 194 ml/min). The ratio of the SMA and SA blood flows (621 ml/min) to the portal venous blood flow (734 ml/min) was 0.85 in the control subjects. The mean portal venous blood flow (1261 ml/min) and the portal venous velocity (14.6 cm/s) were higher in the patients with recanalized para-umbilical veins than in the volunteers and in the patients without recanalized para-umbilical veins. The SMA and SA blood flows were significantly increased in patients with cirrhosis compared with volunteers. Splanchnic inflow (the sum of the SMA and SA blood flows) was higher than the portal blood flow in patients with cirrhosis except in the subjects with recanalized para-umbilical veins. SMA and SA resistive index values were significantly higher in these patients than in the volunteers.

CONCLUSION

Splanchnic blood flow and splanchnic vascular impedance increased significantly in patients with advanced post-hepatitic cirrhosis. Splanchnic inflow must not exceed portal venous blood flow in patients with recanalized para-umbilical veins. Portal vein velocity and portal venous blood flow measurements alone are not useful parameters for discriminating patients with cirrhosis from healthy subjects.

摘要

目的

通过双功多普勒超声（US）评估晚期肝炎后肝硬化患者和健康志愿者的门静脉及内脏血流动力学以及内脏血管阻力。

材料与方法

对16例肝硬化患者和24名健康志愿者进行双功多普勒超声检查。我们研究了门静脉、肠系膜上动脉（SMA）和脾动脉（SA）的血管直径、平均流速和平均血流量，并测量了SMA和SA的阻力指数值。

结果

肝硬化患者的平均门静脉血流量（829±264 ml/min）与志愿者（734±194 ml/min）相比，差异无统计学意义。对照组中SMA和SA血流量（621 ml/min）与门静脉血流量（734 ml/min）的比值为0.85。脐旁静脉再通的患者，其平均门静脉血流量（1261 ml/min）和门静脉流速（14.6 cm/s）高于志愿者及脐旁静脉未再通的患者。与志愿者相比，肝硬化患者的SMA和SA血流量显著增加。除脐旁静脉再通的患者外，肝硬化患者的内脏流入量（SMA和SA血流量之和）高于门静脉血流量。这些患者的SMA和SA阻力指数值显著高于志愿者。