肝静脉压梯度水平与临床和内镜参数在非补偿性慢性肝病中的相关性
Amol Sathawane1, Harshal Khobragade2, Sandip Pal1
1Gastroenterology, Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, IND.
Cureus
|January 29, 2024
概括
肝静脉压梯度 (HVPG) 与非补偿性慢性肝病 (CLD) 中的疾病严重程度相关. 较高的HVPG表明更糟糕的结果,包括,静脉和肝脏脑病变.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 临床医学 临床医学
背景情况:
- 通过肝静脉压梯度 (HVPG) 测量的门压与肝纤维化严重程度相关.
- 在肝硬化患者中,HVPG可能提供预后信息,因为门门压力降低会影响生存.
- 了解HVPG与临床参数的关系对于管理不补偿性慢性肝病 (CLD) 至关重要.
研究的目的:
- 研究肝血管压力梯度 (HVPG) 水平与临床/内镜参数之间的相关性.
- 为了评估HVPG和疾病严重性得分之间的关系,在不补偿的CLD患者.
- 确定HVPG在预测慢性肝病并发症中的预后价值.
主要方法:
- 30名失补偿的CLD患者通过导管测量HVPG.
- 收集的临床数据包括血清肌素,胆红素,,白素,前热血素时间 (PT) 和国际正常化比率 (INR).
- 进行了食管胃管腺镜检查 (UGI内镜检查),并计算了儿童-图尔科特-普格 (CTP) 和末期肝病模型 (MELD) 的得分.
主要成果:
- 在MELD得分和HVPG (r=0.754,p<0.001) 和CTP得分和HVPG (r=0.793,p<0.001) 之间观察到强烈的正相关性.
- 在HVPG和脑病变之间发现了中等的正相关性 (r=0.584,p=0.001).
- 血清白蛋白和HVPG之间的强烈负相关性 (r=0.546,p=0.005),表明肝功能恶化与HVPG更高.
结论:
- 根据CTP和MELD得分,HVPG与非补偿性CLD的疾病严重程度有很强的相关性.
- 较高的HVPG与严重的CLD并发症有关,包括,大静脉,以及静脉出血.
- HVPG反映了诸如静脉,,肝脏脑病等后续病症的存在,但不是肝脏疾病的根本原因.
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