COVID-19患者肝脏血液动力学变化:一个横截面研究
Luisa Siciliani1, Giovanni Cappa2, Caterina Zattera2
1Division of Clinical Immunology and Infectious Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. l.siciliani@smatteo.pv.it.
Journal of ultrasound
|April 2, 2025
概括
COVID-19 患者表现出肝脏血流变化,肝血管多普勒波形异常,表明肝脏炎症. 门静脉速度和的大小可以预测这些患者的呼吸道并发症.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 传染性疾病 传染性疾病
- 医疗成像医学成像
背景情况:
- 肝脏生物化学异常在COVID-19中很常见.
- 肝静脉多普勒波形可以反映肝脏功能障碍,类似于肝硬化.
- 超声波 (美国) 可以评估肝脏内血动力学.
研究的目的:
- 在COVID-19患者中调查肝脏的美国特征.
- 与肝静脉多普勒波形和门静脉速度 (PVV) 与炎症标志物相关联.
- 评估这些参数对临床结果的预测值.
主要方法:
- 对57名感染SARS-CoV-2的患者进行横截面研究.
- 床边腹部上部US与B模式和多普勒.
- 肝静脉多普勒波形 (三相,两相,单相) 的分类和肝静脉波形指数 (HVWI) 的计算.
- 门静脉速度 (PVV) 的测量.
主要成果:
- 低的HVWI和高的PVV与升高的LDH,ALT,D-二次和费里丁相关.
- 双相/单相波形与更高的D-二聚合物和费里有关.
- 高PVV和更大的脏直径预测了更糟糕的呼吸结果 (CPAP,输管).
- 最佳的PVV切线:21.7厘米/秒;脏直径切线:9.84厘米.
结论:
- COVID-19患者表现出改变的肝脏内血动力学.
- 肝静脉波形异常可能表明肝炎和纤维化.
- PVV和脏直径是COVID-19中呼吸系统结果的潜在非侵入性预测因素.
更多相关视频
相关概念视频
Portal Hypertension
Portal hypertension is an increase in blood pressure within the portal venous system. Normally, this pressure is less than 5 mmHg. It is considered clinically significant when it rises above 10 mmHg. At this threshold, complications from altered blood flow and venous congestion emerge.EtiologyPortal hypertension arises from conditions that impede blood flow through the liver. The most common cause is cirrhosis, in which chronic liver injury leads to fibrotic scarring. This fibrosis narrows or...
Cirrhosis II: Pathophysiology
Cirrhosis is a progressive chronic liver injury caused by prolonged inflammation, excessive fibrotic remodeling, and impaired regeneration. Over time, repeated hepatic insults disrupt the liver’s architecture and function, leading to reduced blood flow, impaired bile drainage, and diminished metabolic capacity.Pathophysiology of cirrhosisCirrhosis arises from three main responses to chronic liver damage: inflammation, immune activation, and hepatocyte death. These processes lead to structural...
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess the...
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug binding...
Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment
Hepatic impairment, characterized by decreased liver function, does not uniformly mandate adjustments in drug dosage. Whether dosage modifications are necessary depends on various factors related to the drug's metabolism and elimination pathways. If a drug is primarily excreted via the kidneys and bypasses significant hepatic processing, if it undergoes minimal metabolic transformation in the liver, or if it is volatile and primarily expelled through the lungs, dose adjustments may not be...


