[Comparison of Doppler ultrasonography and hepatic venous pressure gradient in assessing portal hypertension in liver cirrhosis].

Phil Ho Jeong, Soon Koo Baik, Yeun Jong Choi, Dong Hoon Park, Moon Young Kim, Hyun Soo Kim, Dong Ki Lee, Sang Ok Kwon, Young Ju Kim, Joong Wha Park, Nam Dong Kim
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Abstract

Background/aims: This prospective study aimed to determine if Doppler ultrasonography can be representative of hepatic venous pressure gradient (HVPG) in assessing the severity of portal hypertension and response to drug reducing portal pressure.

Methods: The HVPG and the parameters of Doppler ultrasonography including portal venous velocity (PVV) and splenic venous velocity, the pulsatility and resistive index of hepatic, splenic and renal arteries were measured in 105 patients with liver cirrhosis. In 31 patients the changes of hepatic venous pressure gradient and portal venous velocity after administration of terlipressin were evaluated. The patients who showed a reduction in HVPG of more than 20% of the baseline were defined as responders to terlipressin.

Results: Any Doppler ultrasonographic parameters did not correlate with HVPG. Both HVPG and PVV showed a highly significant reduction after the administration of terlipressin(-28.3 +/- 3.9%, -31.2 +/- 2.2% respectively). However, PVV decreased significantly not only in responders(31.7 +/- 2.4%) but also in nonresponders(29.5 +/- 6.1%).

Conclusion: Doppler ultrasonography can not be representative of HVPG in assessing the severity of portal hypertension and response to drug reducing portal pressure in liver cirrhosis.

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[多普勒超声与肝静脉压梯度评价肝硬化门静脉高压的比较]。
背景/目的:本前瞻性研究旨在确定多普勒超声是否可以代表肝静脉压梯度(HVPG)评估门静脉高压的严重程度和药物降低门静脉压的反应。方法:测定105例肝硬化患者的HVPG及多普勒超声门静脉速度(PVV)、脾静脉速度、肝、脾、肾动脉搏动性和阻力指数。观察31例患者给予特利加压素后肝静脉压力梯度和门静脉流速的变化。HVPG降低超过基线20%的患者被定义为对特利加压素有反应。结果:各多普勒超声参数与HVPG无相关性。使用特利加压素后HVPG和PVV均显著降低(分别为-28.3 +/- 3.9%和-31.2 +/- 2.2%)。然而,PVV不仅在应答者中显著下降(31.7 +/- 2.4%),在无应答者中也显著下降(29.5 +/- 6.1%)。结论:多普勒超声不能作为评价肝硬化门静脉高压症严重程度及药物降压反应的HVPG指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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