Changes in Distribution of Splenic Venous Flow in the Patients with Cirrhotic Liver

肝硬化患者脾静脉流量分布的变化

• 批准号: 13671350
• 负责人: TAJIRI Takashi
• 金额: $ 1.6万
• 依托单位: Nippon medical school
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2001
• 资助国家: 日本
• 起止时间: 2001 至 2003
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-13671350/
• 关键词: liver cirrhosis; liver volume; portal hemodynamics; Scintiphotosplenoportography; Technetium-99m-diethylenetriaminepentaacetic acid-galactosylated human serum albumin; 代償性肥大; 脾摘; 肝再生; 脾静脈血

We studied the distribution of splenic venous flow in the liver of patients with normal liver (NL group, n=15), chronic hepatitis (CH group, n=8), and liver cirrhosis (LC group, n=13) with the technique of scintiphotosplenoportography (SSP) after percutaneous intrasplenic injection of Technetium-99m-diethylenetriaminepentaacetic asid-galactosyl-human serum albumin (99mTc-GSA). The index of splenic venous flow volume per unit hepatocytes (V_<unit>) was calculated in each hepatic lobe. To compare V value of the left lobe (VL_<unit>) with that of the right lobe (VR_<unit>), predominant index of the left lobe (L/R index) was defined as L/R index=VL_<unit>/VR_<unit>. The median (interquartile range) of L/R index of LC group; 1.22 (1.06-1.70) was significantly higher than that of NL group; 0.83 (0.66-0.92), p<0.001 and CH group; 0.79 (0.69-0.92), p<0.001. L/R index reflects the change of portal hemodynamics in cirrhotic liver and is useful for discrimination between noncirrhosis and cirrhosis. These results suggest that in the liver exposed to continuous damages, splenic venous blood promotes liver fibrosis in the right lobe and eventually flows more into the left lobe with milder fibrosis.

本文应用经皮脾内注射~（99）m锝-二乙烯三胺五乙酸-半乳糖基-人血清白蛋白（~（99）mTc-GSA）后的荧光脾门静脉造影（SSP）技术，观察了正常肝（NL组，n= 15）、慢性肝炎（CH组，n=8）和肝硬化（LC组，n=13）患者的脾静脉血流量分布。计算各肝叶单位肝细胞脾静脉血流量指数（V_<unit>）。为比较左、右叶的V值（VL<unit>_）<unit>，定义左叶优势指数（L/R指数）为L/R指数=VL_<unit>/VR_<unit>。LC组L/R指数的中位数（四分位距）; 1.22（1.06-1.70）显著高于NL组; 0.83（0.66-0.92），p&lt;0.001和CH组; 0.79（0.69-0.92），p&lt;0.001。L/R指数反映了肝硬化门脉血流动力学的变化，对肝硬化与非肝硬化的鉴别有一定意义。这些结果表明，在暴露于连续损伤的肝脏中，脾静脉血促进右叶的肝纤维化，并最终更多地流入左叶，纤维化程度较轻。

项目成果

Tajiri T, Onda M, Yoshida H, Mamada Y, Taniai N: "Endoscopic scleroligation is a superior new technique for preventing recurrence of esophageal varices."J Nippon Med Sch. 69. 160-164 (2002)

Tajiri T、Onda M、Yoshida H、Mamada Y、Taniai N：“内窥镜硬化术是预防食管静脉曲张复发的一种优越的新技术。”J Nippon Med Sch。

Taniai N, Onda M, Tajiri T, Yoshida H, Mamada Y: "Combined endoscopic and radiologic intervention to treat esophageal varices."Hepato-Gastroenterol. 49. 984-988 (2002)

Taniai N、Onda M、Tajiri T、Yoshida H、Mamada Y：“结合内窥镜和放射学干预治疗食管静脉曲张。”肝胃肠病学。

Tajiri T, Onda M, Yoshida H, Mamada Y, Taniai N, Yamashita K: "Comparison of the long-term results of distal splenorenal shunt and esophageal transection for the treatment of esophageal varices."Hepato-Gastroenterol. 47. 1619-1621 (2000)

Tajiri T、Onda M、Yoshida H、Mamada Y、Taniai N、Yamashita K：“远端脾肾分流术和食管横断术治疗食管静脉曲张的长期结果比较。”肝胃肠病学。

Taniai N, Onda M, Tajiri T, Yoshida H, Mamada Y: "Interventional radiology and endoscopic therapy for rucurrent esophageal varices."Hepato-Gastroenterol. 48. 133-136 (2001)

Taniai N、Onda M、Tajiri T、Yoshida H、Mamada Y：“复发性食管静脉曲张的介入放射学和内窥镜治疗。”肝胃肠病学。

Tajiri T. et al.: "Long-term hematological effects of partial splenic embalization in hepatic cirrhosis"Hepato-Gastroenterology. 49. 1445-1448 (2002)

Tajiri T. 等人：“肝硬化部分脾栓塞的长期血液学影响”肝胃肠病学。