PULMONARY-HYPERTENSION COMPLICATING PORTAL-HYPERTENSION - PREVALENCE AND RELATION TO SPLANCHNIC HEMODYNAMICS
PULMONARY-HYPERTENSION COMPLICATING PORTAL-HYPERTENSION - PREVALENCE AND RELATION TO SPLANCHNIC HEMODYNAMICS
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DOI：
10.1016/0016-5085(91)90225-a
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发表时间：
1991-02-01
期刊：
影响因子：
29.4
通讯作者：
BENHAMOU, JP
中科院分区：
文献类型：
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作者：
HADENGUE, A;BENHAYOUN, MK;BENHAMOU, JP
前瞻性研究了507例因门脉高压而住院但无已知肺动脉高压且接受心导管检查的患者的肺动脉高压患病率。这些患者中有10例（2%）患有原发性肺动脉高压，其中6例无临床症状。第二，对26例症状性肺动脉高压合并门脉高压患者进行了回顾性分析。在诊断门静脉高压后，有外科分流术的患者（10例）比无分流术的患者（147 ± 49个月vs. 44 ± 27个月;P< 0.0001）更晚发生肺动脉高压。心脏指数与肺动脉压呈负相关（r=-0.45;P< 0.01），5例死于肺动脉高压的患者的心脏指数低于5例死于肝功能衰竭的患者（1.52 ± 0.14 vs. 3.69 ± 1.88 L/min · m2;P< 0.05）。第三，比较了285名酒精性肝硬化患者和29名对照者的全身和内脏血流动力学。肺血管阻力升高与门静脉压力、奇静脉血流量或心脏指数升高之间无显著相关性。肺动脉高压比以前估计的门脉高压患者更常见。发生肺动脉高压的风险可能随着门脉高压持续时间的增加而增加，但与门脉高压程度、肝功能衰竭或分流血量无明显关系。
The prevalence of pulmonary hypertension in 507 patients hospitalized with portal hypertension but without known pulmonary hypertension who underwent cardiac catheterization was prospectively studied. Ten (2%) of these patients, 6 of whom were clinically asymptomatic, had primary pulmonary hypertension. Second, 26 patients with symptomatic pulmonary hypertension complicating portal hypertension were reviewed. Pulmonary hypertension occurred later after diagnosis of portal hypertension in patients with a surgical shunt (10 patients) than in those without a shunt (147 ± 49 vs. 44 ± 27 months;P< 0.0001). Cardiac index correlated inversely with pulmonary arterial pressure (r= −0.45;P< 0.01) and was lower in the 5 patients who died of pulmonary hypertension than in the 5 who died of liver failure (1.52 ± 0.14 vs. 3.69 ± 1.88 L/min · m2;P< 0.05). Third, systemic and splanchnic hemodynamics were compared in 285 patients with alcoholic cirrhosis and 29 controls. No significant relation was found between elevated pulmonary vascular resistance and increased portal pressure, azygos blood flow, or cardiac index. Pulmonary hypertension is considerably more frequent than was previously estimated in patients with portal hypertension. The risk of developing pulmonary hypertension could increase with the duration of portal hypertension without any clear relation to the degree of portal hypertension, hepatic failure, or amount of blood shunted.