[The significance of clinical findings in evaluating the degree of portal hypertension in patients with liver cirrhosis].
In 21 patients with bioptically confirmed cirrhosis of the liver catheterization of the lesser circulation and hepatic veins was performed. The portohepatic gradient was considered a measure of the portal pressure. The authors did not find a statistically significant relationship between the portohepatic gradient and the presence of oesophageal varices, haemorrhage into the gastrointestinal tract, biochemical parameters (albumin, gamma-globulin and bilirubin level) and the prothrombin time. The portohepatic gradient was not significantly related with the central venous pressure, the median pressure in the pulmonary artery and the pressure in the wedged pulmonary capillaries. It was, however, significantly higher in patients with ascites (p less than 0.05); patients in group B and C of Child-Turcott's classification had a portal gradient which was significantly higher than in patients of group A (p less than 0.01). The value of the cardiac index and the systemic vascular resistance was not related to values of the portohepatic gradient; a hyperkinetic circulation which a cardiac index above 4.5 l/min/m2 was recorded only in three patients. Based on the above results, the authors assume that a hyperkinetic circulation in patients of groups A and B according to Child-Turcott's classification is not a frequent finding and is not related to the value of the portal pressure. In the author's opinion the most suitable clinical indicator of the degree of portal hypertension is Child-Turcott's classification.
Jedlicka
J
J
Petrtýl
J
J
Tesar
V
V
Marecek
Z
Z
Cervinka
J
J
Kordac
V
V
D000328:Adult; D000368:Aged; D004932:Esophageal and Gastric Varices / Q000150:complications; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000175:diagnosis* / Q000209:etiology; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged
Význam klinických nálezů pro hodnoceni stupnĕ portální hypertenze u nemocných s jaterní cirhózou.