肝静脉压力梯度在门静脉高压全病程管理中的作用

Role of hepatic venous pressure gradient in the overall management process of portal hypertension

门静脉高压是各种慢性肝病的常见并发症,是影响患者临床预后的重要因素,门静脉高压可导致食管胃底静脉曲张、消化道出血、腹水、自发性腹膜炎、肾功能不全、脾功能亢进、肝肺综合征等一系列严重并发症的出现;肝静脉压力梯度是间接反映门静脉压力的临床最佳指标,是目前诊断临床显著性门静脉高压的金标准,并且肝静脉压力梯度在预测肝硬化程度、门静脉高压静脉曲张出血风险及结局、腹水的产生、降低门静脉高压药物以及抗病毒药物疗效等方面都具有重要的应用价值,同时基于门静脉压力梯度的个体化治疗在门静脉高压患者的全程管理中具有重要理论和临床意义,为门静脉高压患者的个体化治疗提供新的临床思路。

Portal hypertension is a common complication of many chronic liver diseases and an important factor affecting the clinical prognosis of patients.Portal hypertension can bring a series of serious complications such as esophagogastric varices,gastrointestinal bleeding,ascites,spontaneous peritonitis,renal insufficiency,hypersplenism,and hepatopulmonary syndrome.Hepatic venous pressure gradient is the best clinical indicator that indirectly reflects the portal venous pressure.Currently,it is the gold standard test for diagnosing clinically significant portal hypertension.In addition,the hepatic venous pressure gradient has important application value in predicting the degree of liver cirrhosis,the risk and prognosis of portal hypertension variceal bleeding,ascites production,portal hypertension drugs reduction,and antiviral drugs efficacy.At the same time,individualized treatment based on portal pressure gradient has important theoretical and clinical significance,and provides new clinical ideas in the overall management of patients with portal hypertension.