Doppler ultrasonografi ile, farkli evrelerdeki sirozlu hastalarda hemodinamik inceleme
Hemodynamic evaluation by doppler ultrasonography in different grades of cirrhosis
- Ana Sayfa
- Sayılar
- Doppler ultrasonografi ile, farkli evrelerdeki sirozlu hastalarda hemodinamik inceleme...
Özet
Giris ve amaç: Sirozlu hastalarda Doppler ultrasonografi (DUS) ile incelenen hemodinamik degisiklikler ile portal hipertansiyon veya karaciger fonksiyon bozuklugunun siddeti arasindaki iliski hakkindaki çalismalar yetersizdir. Sirozlu hastalarda portal, hepatik, splanknik ve renal dolasimdaki hemodinamik degisiklikleri arastirdik. Gereç ve yöntem:35 sirozlu hasta (11 Child A, 12 Child B, 12 Child C ) ve 13 saglikli kontrol çalismaya alindi. DUS ile SMA’ de maksimum akim hizi (MAH), rezistivite indeksi (RI) ve pulsatilite indeksi (PI), hepatik ve renal arterlerde RI ve PI, portal vende ise çap, MAH ve debi ölçüldü. Bulgular: SMA’ de; MAH’ i; Child A, B ve C gruplarinda kontrol grubuna göre (p her üçünde de <0.001), Child C grubunda Child A grubuna göre anlamli seviyede yüksekti (p<0,001), Child B grubu ile Child A ve C gruplari arasinda ise anlamli farklilik yoktu. RI ve PI; SMA, hepatik ve renal arterlerde; Child A, B ve C gruplarinda, kontrol grubuna göre anlamli derecede yüksekti, Child A, B ve C gruplari arasinda ise farklilik saptanmadi. Portal ven çapi, MAH ve debi degerleri Child evresi ilerledikçe belirgin olarak azalmasina ragmen istatistiki olarak anlamlilik yoktu. Sonuç: Portal ven çapi, MAH’i ve debisi sirozun evresi arttikça belirgin olarak azalmaktadir, siroz hastalarinin takibinde ve prognoz tayininde bu parametrelerden de yararlanilabilir.
Abstract
Background and aims: The data about the relation between the severity of liver dysfunction and portal hypertension and changes in the hemodynamic parameters obtained by Doppler US (DUS) in cirrhotic patients are insufficient. We evaluated the hemodynamic changes in portal, splanchnic, hepatic and renal arteries in patients with cirrhosis. Materials and methods: 35 consecutive cirrhotic patients (11 patients in Child A, and 12 patients each in Child B and C groups) and 13 healthy subjects as control group were included in the study. Using DUS, peak systolic flow velocity (PSFV), resistivity (RI) and pulsatility index (PI) were measured at SMA; RI and PI were measured at renal and hepatic arteries. The diameter, maximal flow velocity and flow volume of portal vein were measured. Results: PSFV values obtained at SMA were sigficantly higher in Child A, B and C groups than in control group (p <0.001 in each group) and were significantly higher in Child C group than in Child A group (p<0.001). No significant difference was found between Child B and A groups. RI and PI values obtained at SMA, hepatic and renal arteries were significantly higher in Child A, B and C groups than in control group (p<0.001). There was no significant difference in RI and PI values among Child A, B and C groups at SMA, hepatic and renal arteries. There was a marked but not significant decrease in the diameter, flow velocity and flow volume values among Child A, B and C groups at portal vein. Conclusion: Diameter, flow velocity and flow volume values at portal vein decrease markedly as the stage of the cirrhosis increases. These parameters could be used in follow-up and prognosis assessment of cirrhotic patients.
