[Hepatopulmonary syndrome characteristics in hepatic cirrhosis associated with COPD].
OBJECTIVE
To evaluate specific features of hepatopulmonary syndrome (HPS) in patients with cirrhosis and cirrhosis associated with chronic obstructive pulmonary disease (COPD).


METHODS
We made a retrospective analysis of case histories of 75 patients with hepatic cirrhosis (HC) of different etiology. The patients were divided into two groups: 23 patients with HC and COPD (group 1); 52 patients with HC without COPD (group 2). The patients were examined with spirography, gasometry. Single-breath carbon monoxide diffusion capacity (Dlco), TCO and TCO/VA were estimated. Transthoracic contrast-enhanced echocardiography was conducted for detection of intrapulmonary bypass in AaDO2 > 15 mm Hg.


RESULTS
COPD stage I and II were diagnosed in 14 of 23 and 9 of 23 patients of group 1, respectively. TCO and TCO/VA had a trend to lowering in group 1 (p > 0.05). PaO2 was lower (p < 0.05) while AaDO2 was higher (p < 0.05) in group 1. Four patients of group I had intrapulmonary bypasses: of the first degree (2 patients with hypoxemia) and of the first and second degree (2 patients with normoxemia). In group 2 three patients had intrapulmonary bypasses: of the fourth degree in 1 patient with hypoxemia and of the first and second degree in 2 patients with normoxemia.


CONCLUSIONS
HC patients with COPD had more severe hypoxemia. Mild and moderate HPS were registered in both groups. In COPD the risk of HPS is 3 times higher.
Nevzorova
V A
VA
Pestrikova
T L
TL
Kochetkova
E A
EA
Osvald
M
M
Doutreleau
S
S
Massard
G
G
D000368:Aged; D005260:Female; D020065:Hepatopulmonary Syndrome / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000032:analysis; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D012189:Retrospective Studies
D009569:Nitric Oxide