BLUNTED POSTPRANDIAL REACTION OF PORTAL VENOUS FLOW IN CHRONIC LIVER-DISEASE, ASSESSED WITH DUPLEX-DOPPLER - SIGNIFICANCE FOR PROGNOSIS
BLUNTED POSTPRANDIAL REACTION OF PORTAL VENOUS FLOW IN CHRONIC LIVER-DISEASE, ASSESSED WITH DUPLEX-DOPPLER - SIGNIFICANCE FOR PROGNOSIS
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DOI：
10.1016/s0168-8278(05)80603-8
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发表时间：
1994-12-01
影响因子：
25.7
通讯作者：
VANHATTUM, J
中科院分区：
文献类型：
--
作者：
DEVRIES, PJ;DEHOOGE, P;VANHATTUM, J
为了确定进餐对门静脉血流的影响以及该参数的预后价值，对46例慢性肝病患者和28例健康受试者在进餐前后进行了双功多普勒检查。在40名患者和21名健康受试者中完成了测量。测量餐后门静脉直径、血流速度和定量血流60分钟。平均基线值分别为：11.4 mm与10.2 mm（p=0.019），10.8 cm.s（-1）与13.4 cm.s（-1）（p=0.015）和668 ml.min（-1）与646 ml.min（-1）（p=0.7）。脾脏大小分别为15.0 cm和10.6 cm（p=0.0001）。患者和对照组的餐后直径、流速和流量显著增加（所有患者p=0.0001）。餐后平均血流量可用抛物线多项式方程描述。患者的曲线比对照组更钝，具有显著不同的回归常数（p=0.025和p=0.029）。对所有受试者的生存和静脉曲张出血进行随访。平均随访时间为47个月。早期最大餐后血流速度（p=0.041）和脾脏大小（p=0.002）与生存预后不良显著相关。早期最大流速也与静脉曲张出血增加有关。这项研究表明慢性肝病患者餐后门静脉血流变钝。餐后门静脉血流量可能具有预后意义。(C)肝病学杂志。
To establish the effects of a meal on portal venous flow and the prognostic value of this parameter, 46 patients with chronic liver disease and 28 healthy subjects were examined with duplex Doppler before and after a meal. The measurements were completed in 40 patients and 21 healthy subjects. Postprandial portal venous diameter, blood velocity and quantitative flow were measured for 60 min. Mean baseline values were: 11.4 mm versus 10.2 mm (p=0.019), 10.8 cm.s(-1) versus 13.4 cm.s(-1) (p=0.015) and 668 ml.min(-1) versus 646 ml.min(-1) (p=0.7) respectively. Spleen size was 15.0 cm versus 10.6 cm (p=0.0001) respectively. Postprandial diameter, velocity and flow increased significantly in patients and controls (p=0.0001 for all). Mean postprandial flow could best be described by a polynomial equation with a parabolic curve. Patients' curves were more blunted than controls', with significantly different regression constants (p=0.025 and p=0.029). All subjects were followed up for survival and variceal haemorrhage. The mean follow-up time was 47 months. Early maximum postprandial velocity (p=0.041) and large spleen size (p=0.002) were significantly related to an unfavourable prognosis for survival. Early maximum velocity was also related to increased variceal haemorrhage. This study shows that postprandial portal venous flow is blunted in patients with chronic liver disease. Postprandial portal venous flow may have prognostic significance. (C) Journal of Hepatology.