各种间接门压梯度与实际门压梯度之间的相关性和一致性分析
Rufeng Chen1,2,3, Yaozu Liu1,2,3, Li Ma1,2,3
1Shanghai Institution of Medical Imaging, Fudan University, Shanghai, China.
该研究发现,I-HVPG测量与门压梯度 (PPG) 密切相关,对于接受TIPS的患者来说,可能是F-HVPG的可靠替代品. 测量HVPG不应该排除患者从TIPS干预.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 干预性放射学 干预性放射学
- 心血管生理学心血管生理学
背景情况:
- 门高血压管理需要精确的压力梯度测量.
- 肝血管压力梯度 (HVPG) 是一个关键的血液动力学参数.
- 计算HVPG存在不同的方法,需要进行比较.
研究的目的:
- 评估F-HVPG,I-HVPG和门压梯度 (PPG) 之间的相关性和一致性.
- 为了确定I-HVPG的可靠性,作为F-HVPG和PPG测量的替代方案.
- 评估HVPG在将患者排除在TIPS干预之外的有用性.
主要方法:
- 对112名接受TIPS治疗的门性高血压患者的回顾性分析.
- 在手术期间收集自由肝静脉压力 (FHVP),下静脉腔压力 (IVCP),状肝静脉压力 (WHVP) 和门静脉压力 (PVP).
- 使用皮尔森相关性和布兰德-阿尔特曼方法进行统计分析.
主要成果:
- F-HVPG和I-HVPG显示高相关性 (r=0.946) 和一致性.
- 在整体队列中,I-HVPG与PPG (r=0.698) 与F-HVPG (r=0.667) 相比,I-HVPG与PPG的相关性更为密切.
- 在FHVP-IVCP>2mmHg的患者中,I-HVPG与PPG的相关性比F-HVPG (r=0.648) 更强 (r=0.807).
- 布兰德-阿尔特曼分析表明,I-HVPG与PPG的协议限制较窄.
结论:
- F-HVPG和I-HVPG高度相关且一致.
- I-HVPG似乎是一个比F-HVPG更可靠的PPG指标.
- 由于可能低估PPG,不应使用HVPG测量来排除患者从跨内肝移植系统分流 (TIPS) 程序中.
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