BLUNTED POSTPRANDIAL REACTION OF PORTAL VENOUS FLOW IN CHRONIC LIVER-DISEASE, ASSESSED WITH DUPLEX-DOPPLER - SIGNIFICANCE FOR PROGNOSIS

被引:15
作者
DEVRIES, PJ
DEHOOGE, P
HOEKSTRA, JBL
VANHATTUM, J
机构
[1] DIAKONESSEN HOSP,DEPT DIAGNOST IMAGING,UTRECHT,NETHERLANDS
[2] DIAKONESSEN HOSP,DEPT INTERNAL MED,UTRECHT,NETHERLANDS
来源
JOURNAL OF HEPATOLOGY | 1994年 / 21卷 / 06期
关键词
CIRRHOSIS; ESOPHAGUS; HEMORRHAGE; LIVER; PROGNOSIS; VARICES;
D O I
10.1016/S0168-8278(05)80603-8
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
To establish the effects of a meal on portal venous flow and the prognostic value of this parameter, 46 patients with chronic liver disease and 28 healthy subjects were examined with duplex Doppler before and after a meal. The measurements were completed in 40 patients and 21 healthy subjects. Postprandial portal venous diameter, blood velocity and quantitative flow were measured for 60 min. Mean baseline values were: 11.4 mm versus 10.2 mm (p=0.019), 10.8 cm.s(-1) versus 13.4 cm.s(-1) (p=0.015) and 668 ml.min(-1) versus 646 ml.min(-1) (p=0.7) respectively. Spleen size was 15.0 cm versus 10.6 cm (p=0.0001) respectively. Postprandial diameter, velocity and flow increased significantly in patients and controls (p=0.0001 for all). Mean postprandial flow could best be described by a polynomial equation with a parabolic curve. Patients' curves were more blunted than controls', with significantly different regression constants (p=0.025 and p=0.029). All subjects were followed up for survival and variceal haemorrhage. The mean follow-up time was 47 months. Early maximum postprandial velocity (p=0.041) and large spleen size (p=0.002) were significantly related to an unfavourable prognosis for survival. Early maximum velocity was also related to increased variceal haemorrhage. This study shows that postprandial portal venous flow is blunted in patients with chronic liver disease. Postprandial portal venous flow may have prognostic significance. (C) Journal of Hepatology.
引用
收藏
页码:966 / 973
页数:8
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