肝静脉压力梯度在慢性肝脏疾病评估中的应用

Application of HVPG in assessment of chronic liver diseases

慢性肝病评估体系的建立和完善对于临床诊疗具有指导意义,肝静脉压力梯度(HVPG)在慢性肝病进展过程中有着重要意义,是目前唯一独立于病因学之外指导治疗的病理生理学指标。简述了慢性肝病现有的评估手段,对HVPG在慢性肝病评估中的应用作了系统描述,包括HVPG在预测肝硬化程度、门静脉高压静脉曲张出血风险及结局、肝硬化腹水的产生、降低门静脉高压药物以及抗病毒药物疗效和肝癌术后结局等方面的应用。认为HVPG测量对于慢性肝病的疾病进展与预后具有重要的评估作用,是一种能够预测慢性肝病转归的有效指标。

The establishment and perfection of the assessment system for chronic liver diseases have a guiding significance for clinical diagnosis and treatment. Hepatic venous pressure gradient （HVPG） is of great significance in the progression of chronic liver diseases, and it is the only pathophysiological index for treatment independent of etiology. The current methods for evaluation of chronic liver diseases are simply described, and the application of HVPG in evaluation of chronic liver diseases is systematically summarized, including predicting the se- verity of liver cirrhosis, variceal bleeding risk and outcome of portal hypertension, development of cirrhotic ascites, efficacy of drugs for reducing portal hypertension and antiviral drugs, and postoperative outcome of liver cancer. It is thought that HVPG measurement plays an im- portant role in the assessment of the progression and prognosis of chronic liver diseases and is an effective predictor of outcome.