Spontaneous portosystemic shunt diameter predicts liver function after balloon-occluded retrograde transvenous obliteration.
Spontaneous portosystemic shunt diameter predicts liver function after balloon-occluded retrograde transvenous obliteration.
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DOI：
10.1002/jgh3.12712
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Enomoto N
中科院分区：
文献类型：
--
作者：
Tatsumi A;Maekawa S;Osawa L;Katoh R;Komiyama Y;Nakakuki N;Takada H;Matsuda S;Muraoka M;Suzuki Y;Sato M;Takahashi E;Miura M;Amemiya F;Takano S;Fukasawa M;Yamaguchi T;Nakayama Y;Inoue T;Okada H;Araki T;Onishi H;Enomoto N
最近，用于自发性门体分流术（SPSS）的球囊闭塞逆行经静脉闭塞术（BRTO）作为改善肝硬化门脉高压患者肝功能的措施而受到关注。然而，尚不清楚SPSS直径是否与BRTO后肝静脉压力梯度（HVPG）和肝功能的变化相关。在 34 名因肝性脑病/胃静脉曲张接受 BRTO 的肝硬化患者中，研究了基线时和 BRTO 后 6 个月时 SPSS 直径与肝功能的关系以及随之而来的 HVPG 变化。患者的Child-Pugh (CP)评分为A/B/C (7/19/8)，SPSS直径≤10mm/11-20mm/<20mm(8/21/5)，平均观察期为3.2(0.3-8.5)年。 SPSS 直径与基线时的男性、饮酒以及白蛋白、凝血酶原时间 (PT%) 和 NH3 值显着相关。此外，SPSS 直径与 BRTO 观察到的 HVPG 变化显着相关（r = 0.55，P = 0.005），并且大分流直径与 HVPG 的更大增加显着相关。 6 个月时，观察到白蛋白、PT%、胆红素和 NH3 总体显着改善，但如果具有 CP A/B，则分流直径较大的患者改善更为明显。 SPSS 直径与基线时和 BRTO 后的肝功能以及 HVPG 的变化密切相关，表明 SPSS 直径是 BRTO 结果的重要预测因子。肝硬化时的肝功能与SPSS直径呈负相关，分流直径的增加伴随着肝功能障碍的加剧。 BRTO 后观察到的 HVPG 增加 (ΔHVPG) 与 SPSS 直径显着相关。 BRTO 肝功能的改善取决于 SPSS 直径，尤其是当肝功能保留在 Child-Pugh A 或 B 范围内时。
Recently, balloon‐occluded retrograde transvenous obliteration (BRTO), performed for spontaneous portosystemic shunts (SPSS), has been receiving attention as a measure to improve liver function in cirrhotic patients with portal hypertension. However, it is unclear whether SPSS diameter is associated with changes in hepatic venous pressure gradient (HVPG) and liver function after BRTO. In 34 cirrhotic patients receiving BRTO for hepatic encephalopathy/gastric varices, the association of SPSS diameter with liver function at baseline and 6 months after BRTO and the accompanying changes in HVPG were investigated. Patients had Child–Pugh (CP) scores of A/B/C (7/19/8), SPSS diameters of ≤10 mm/11–20 mm/<20 mm (8/21/5), and an average observation period of 3.2 (0.3–8.5) years. SPSS diameter was significantly associated with male sex, alcohol use, and values of albumin, prothrombin time (PT%), and NH3 at baseline. Moreover, the SPSS diameter was significantly correlated with the changes in HVPG observed upon BRTO (r = 0.55, P = 0.005), and a large shunt diameter was significantly associated with a greater increase in HVPG. At 6 months, significant improvements in albumin, PT%, bilirubin, and NH3 were observed overall, but the improvement was marked in those with larger shunt diameters if they had CP A/B. SPSS diameter was strongly associated with liver function at baseline and after BRTO and also with changes in HVPG, indicating that SPSS diameter is an important predictor of BRTO outcome. Liver function in liver cirrhosis was negatively associated with the SPSS diameter, and an increase in shunt diameter was accompanied by an exacerbation of liver dysfunction. HVPG increase (ΔHVPG) observed after BRTO was significantly associated with the SPSS diameter. The improvement in liver function with BRTO was dependent on the SPSS diameter, especially when liver function was preserved in the Child–Pugh A or B range.
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影响因子：
4.6
作者：
Allard, Marc-Antoine;Akamatsu, Nobuhisa;Hasegawa, Kiyoshi
通讯作者：
Hasegawa, Kiyoshi
DOI：
10.1046/j.1440-1746.2003.03087.x
发表时间：
2003-08-01
影响因子：
4.1
作者：
Miyamoto, Y;Oho, K;Sata, M
通讯作者：
Sata, M
DOI：
10.1016/j.jvir.2016.03.031
发表时间：
2016-08-01
影响因子：
2.9
作者：
Yamamoto, Akira;Nishida, Norifumi;Miki, Yukio
通讯作者：
Miki, Yukio
DOI：
10.1111/j.1440-1746.1996.tb00010.x
发表时间：
1996-01-01
影响因子：
4.1
作者：
Kanagawa, H;Mima, S;Okuda, K
通讯作者：
Okuda, K
影响因子：
19.7
作者：
Nardelli, Silvia;Riggio, Oliviero;Schepis, Filippo
通讯作者：
Schepis, Filippo