摘要
目的探讨血红蛋白浓度对肝硬化门静脉高压症(PHT)患者高血流动力状态的影响。方法收集近1年半内接受断流或联合手术治疗的5 5例PHT患者的资料。按血红蛋白是否低于1 1 0 g/L分为贫血和非贫血组,检测相关的临床和血流动力学指标,为排除不同肝功能对研究的影响,按Child分级对数据分层后研究血红蛋白对血流动力学的影响。结果贫血组和非贫血组相比,心排量[(7.4±1.7)L/m in vs(6.3±1.9)L/m in,P=0.0 2 8]和自由门静脉压[(2 9.1±3.1)mmHg vs(2 6.8±3.3)mmHg,P=0.0 1 2](1mmHg=0.1 3 3 kPa)明显升高,平均动脉压[(8 4±10.7)mmHg vs(9 7.1±1 2)mmHg,P<0.0 1]和全身血管阻力[(8 6 6±2 1 5)dyn/(s.cm5)vs(1 2 0 7±3 1 7)dyn/(s.cm5),P<0.0 1]显著下降。按Child A和Child B-C分层后对数据的分析得出相似的结果。多元回归分析表明,血红蛋白浓度和白(清)蛋白浓度是影响PHT患者全身血管阻力的独立相关因素。结论贫血会进一步恶化PHT患者的高血流动力状态。血红蛋白浓度是评估PHT患者血流动力学状态的重要参数之一。
Objective To investigate the effects of hemoglobin concentration on portal hypertension associated with hyperdynamie state. Methods According to blood hemoglobin level below or above 110g/L, 55 nontreated portal hypertension patients were divided into anemic and nonanemie groups, and the relevant hemodynamie and clinical data were examined anti analyzed retrospeetively. In order to avoid the effects of differences in hepatic function, data were analyzed separately according to the Child class. Results Compared to the nonanemic group, the anemic group had markedly increased cardiac output [（ 7. 4 ±1.7L）/min vs （6. 3±1.9L）/min, P = 0. 028 ] and increased free portal pressure [ （29. 1± 3. 1 ） mmHg vs （ 26. 8±3. 3 ） mmHg , P = 0. 012] , and a markedly decreased mean arterial pressure [ （ 84 ± 10.7）mmHg vs （97.1± 12）mmHg, P 〈0.01] and systemic vaseular resistance [ （866±215）dyn/ （s·cm^5）vs （ 1207±317） dyn/（s·cm^5 ） , P 〈0. 01]. Similar results were obtained when Child A and Child B-C patients were analyzed separately. Multivariate logistic regression disclosed that hemoglobin concentration, as well as albumin concentration, was an independent factor influencing the systemic vascular resistance in PHT patients. Conclusions Anemia further aggravates the hyperdynamic circulation of portal hypertension. Hemoglobin concentration is an important parameter to evaluate the hemodynamic status of PHT patients.
出处
《中国普通外科杂志》
CAS
CSCD
2005年第12期905-908,共4页
China Journal of General Surgery
关键词
血红蛋白测定
血流速度
高血压
门静脉
Hemogiobinometry
Blood Flow Velocity
Hypertension, Portal
