肝硬化肾血液动力学改变的临床意义

The Change of Intrarenal Arterial Hemodynamics in Liver Cirrhosis

目的：为尽早判定肝硬化患者肾血液动力学状态，利用彩色多普勒观测肾功能正常的１５例肝硬化腹水患者（Ⅰ组）、１５例肝硬化无腹水患者（Ⅱ组）、１２例非肝病腹腔肿瘤腹水患者（Ⅲ组）及２０例正常受试者（Ⅳ组）肾内动脉阻力指数（ＲＩ）。结果：Ⅰ组肾ＲＩ值（０．７５７±０．０３）显著高于Ⅱ组（０．６３５±０．０６）、Ⅲ组（０．６３８±０．０２）及Ⅵ组（０．６２８±０．０３）（Ｐ＜０．０１），Ⅱ组、Ⅲ组、Ⅳ组肾ＲＩ值无显著差异（Ｐ＜０．０５），Ⅰ组肾ＲＩ值均＞０．７。结论：在肾功能正常时，肝硬化无腹水患者肾血流者动力学状态基本稳定，肝硬化腹水患者，肾内血管阻力升高，肾血流动力学已发生紊乱，有发生肝肾综合征（ＨＲＳ）的趋势，对临床预防与诊治ＨＲＳ有重要意义。

Purpose:We performed intrarenal arterial Dopplers studies on 15 patients with cirrhosis and ascites(group Ⅰ),15 patients with cirrhosis but no ascites(group Ⅱ)and 20 healthy subjects(group Ⅲ).A mean resistive index(RI) was calculated for each patient.All patients had normal renal function.Results:The mean RI of the group Ⅰ(0757±003)was significantly higher than that of the normal group(0628±003) and group Ⅱ (0635±006)(P<001).There was no differencein RIbetween group Ⅱ and group Ⅲ (P>005).Conclusion:The results showed cirrhotic patients with ascites had renalvasoconstriction even in the absence of clincally apparent renalimpaired.Patients with compensated cisshosis had normal renal hemodynamics.We think RI contributes useful information to evaluate hepatorenal syndrome.