Serum hyaluronic acid concentration in Fontan circulation: correlation with hepatic function and portal vein hemodynamics.
Serum hyaluronic acid concentration in Fontan circulation: correlation with hepatic function and portal vein hemodynamics.
复制标题
Fontan 循环中血清透明质酸浓度：与肝功能和门静脉血流动力学的相关性。
DOI：
10.1007/s00246-013-0827-9
复制
发表时间：
2014
影响因子：
1.6
通讯作者：
Oka A.
中科院分区：
文献类型：
--
作者：
Hayashi T1;Inuzuka R;Shindo T;Hirata Y;Shimizu N;Oka A.
虽然肝纤维化在Fontan手术的术后后期引起显著的发病率，但肝纤维化的血清标志物透明质酸（HA）在Fontan患者中的诊断价值尚未确定。本研究的目的是确定Fontan患者血清HA浓度升高是否与门静脉（PV）吸气呼气流速比（Qin/Qex）升高相关，这是肝纤维化的指标。我们回顾性研究了28例因各种适应症接受心脏导管插入术的Fontan循环患者。检查时的中位年龄为5.5岁（范围2.2-5.6岁）。中位HA浓度为17.7 ng mL−1（范围10.0-82.1），用于将我们的28例患者分为两组。高HA组患者PV的Qin/Qex显著高于低HA组患者（1.25 ± 0.12vs.1.12 ± 0.11，p < 0.05）。高HA组的血小板计数显著较低（216 ± 74 vs. 294 ± 104 × 109 L −1，p< 0.05）。下腔静脉压力无显著差异。总之，Fontan患者中HA浓度的增加伴随着肝硬化特有的PV血流动力学变化，可能是肝纤维化的早期指标。
Although liver fibrosis causes significant morbidity in the late postoperative period of the Fontan procedure, the diagnostic value of hyaluronic acid (HA), a serum marker of liver fibrosis, has not been established in Fontan patients. The purpose of this study was to determine whether increased serum HA concentration in Fontan patients is associated with an increase in inspiratory-to-expiratory flow rate ratio (Qin/Qex) of the portal vein (PV), which is indicative of liver fibrosis. We retrospectively studied 28 consecutive patients with Fontan circulation who underwent cardiac catheterisation for various indications. The median age at examination was 5.5 years (range 2.2–5.6). The median HA concentration was 17.7 ng mL−1(range 10.0–82.1), which was used to divide our 28 patients into two groups. Patients in the high-HA group had significantly greater Qin/Qex of the PV than those in the low-HA group (1.25 ± 0.12 vs. 1.12 ± 0.11,p< 0.05). Platelet counts were significantly lower in the high-HA group (216 ± 74 vs. 294 ± 104 × 109L−1,p< 0.05). No significant difference was found in inferior vena caval pressure. In conclusion, increase of HA concentration in Fontan patients accompanies the change in PV hemodynamics peculiar to liver cirrhosis and might be an early indicator of liver fibrosis.