Changes Porto-hepatic Blood Flow in Patients with Cirrhosis of the Liver, Combined with Chronic Bronchitis
##plugins.themes.bootstrap3.article.sidebar##
##plugins.themes.bootstrap3.article.main##
Abstract
The objective: study the features of porto1hepatic blood flow in patients with alcoholic liver cirrhosis (ALC) in conjunction with chronic bronchitis (CB) according to Doppler ultrasound.
Patients and methods. The study involved 60 patients who were hospitalized, 20 ALC patients in stage B according to Child-Pugh without CB (Ist group), 20 ALC patients in stage B according to Child-Pugh combined with CB in the acute phase (IInd group), 20 patients exacerbation of chronic bronchitis, for which there was no evidence of digestive system diseases (IIIrd group). All patients underwent a complex ultrasonic research techniques scanning in B-mode, the VD-mode, color duplex scanning using «Hitachi EUB 7000» ultrasonic scanner connected to the Doppler flourimetr was visualized main arterial and venous vessels of hepatic and splenic pools.
Results. Changes porto-hepatic blood flow were most pronounced in patients with ALC in combination with CB when compared with patients of groups I and III (p<0,05) according to the obtained Doppler indices: diameter of the hepatic artery was 5,55±0,19 mm, portal vein – 12,60±0,17 mm, where increased by 159,12% and 53,56%, respectively (p<0,05) higher than those in healthy individuals.
The diameter of the splenic artery and splenic vein at the ALC for combination with CB significantly increased compared with control on 31,13% and 35,67%, respectively (p<0,05).
Linear and volumetric blood flow rate in portal vein decreased in this group of patients, 60,24% and 22,68%, respectively (p<0,05) compared with healthy individuals, the linear velocity of blood flow in the splenic vein also significantly slowed down compared to the control on 41,06% (p<0,05), and the volumetric blood flow velocity v. lienalis grew by 155,80% (p<0,05).
Among the characteristics of the arterial blood flow hepato-splenic system Gosling pulsatility index (PI) and Pursello resistance index (RI) of hepatic artery also Pursello resistance index (RI) of splenic artery significantly grew in ALC patients in combination with CB 147,20%, 65,49% and 32,31%, respectively (p<0,05) compared with the control group.
Maximal systolic velocity of blood flow in the hepatic artery of patients – grew by 8,95% (p<0,05). End diastolic blood flow velocity in the hepatic artery tended to decrease on 13,36% (p<0,05) compared with healthy individuals.
Conclusion. Violation of porto-hepatic blood flow in patients with ALC is characterized by its redistribution in the veins of the portal system in the direction of the spleen with a decrease in the average linear and the volumetric velocity in the portal and hepatic veins, increasing the resistance index in the interlobar arteries.
##plugins.themes.bootstrap3.article.details##
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain the copyright and grant the journal the first publication of original scientific articles under the Creative Commons Attribution 4.0 International License, which allows others to distribute work with acknowledgment of authorship and first publication in this journal.
References
Шипулін В.П. Цироз печінки: питання терапії / В.П. Шипулін. // Лікарська справа. Врачебное дело. – 2007. – № 1. – С. 36-40.
Самогальська О.Є. Синдром портальної гіпертензії при алкогольних цирозах печінки: механізми формування і методи діагностики [електронний ресурс] / О.Є. Самогальська, Н.В. Лобанець // Новини медицини та фармації. – 2011. – режим доступу до ресурсу: http://www.mif-ua.com/archive/article/21841.
Ягмур В.Б. Показники допплерограми хворих на хронічний гепатит та цироз печінки вірусного походження [Електронний ресурс] / В.Б. Ягмур, А.В. Шевченко // Гастроентерологія Збірник наукових праць. – 2011. – Режим доступу до ресурсу: http://www.nbuv.gov.ua/old_jrn/Chem_Biol/Gastro/2011_45/Yagmurrazd3.pdf.
Фещенко Ю.І. Пульмонологія та фтизіатрія національний підручник / Ю.І. Фещенко, В.П. Мельник, І.Г. Ільницький. – Київ;Львів: Атлас, 2011. – 1365 с.
Харченко Н.В. Алкогольная болезнь органов пищеварения: клинические очерки / Н.В. Харченко, Н.Б. Губергриц. – Киев: Новый друк, 2009. – 180 с.
Сипливый В.А. Портальная гемодинамика и морфологические изменения печени у больных циррозом / В.А. Сипливый, А.Г. Петюнин, В.Д. Марковский. // Клінічна хірургія. – 2012. – № 2. – С. 9-12.
Bolondi L. Doppler flowmetry – clinical applications in portal hypertensive patients. Portal hypertension (clinical and physiological aspects) / L. Bolondi, S. Gaiani, L. Barbara. // Springer Verlag. – 2011. – С. 161-182.
Степанов Ю.М. Современные методы верификации фиброза / Ю.М. Степанов, В.І. Диденко // Здоров’я України Гепатологія. – 2013. – № 4. – С. 30-31.
