Clinical and hemodynamic aspects of hepatic and extrahepatic portal hypertension

Abstract

Background. Significant variability of the quantitative indices of portal blood flow in chronic hepatitis, cirrhosis, chronic heart failure, Budd-Chiari disease confirms the need for further search for clinical and hemodynamic features in various forms of portal hypertension (PH). The purpose was to determine the relationship between dopplerographic indices of the portal system, clinical data and the main markers of cytolytic, cholestatic and mesenchymal-inflammatory syndromes in patients with hepatic and extrahepatic PH. Materials and methods. The study included 205 patients with PH and 35 patients without PH who underwent examination and treatment in the gastroenterology department of the Mykolaiv Regional Clinical Hospital. All patients underwent clinical examination, dopplerography of the portal system vessels, and biochemical blood test. Results. In patients with hepatic PН, the greatest changes in the dopplerographic indices of both venous and arterial blood flow were observed simultaneously with a significant degree of cytolysis and cholestasis markers, and the revealed reliable correlation indicates their associative character. A characteristic feature of extrahepatic hypertension was the absence of signs of liver failure or their lesser severity, and no parallelism was found between biochemical and hemodynamic parameters in this form of PН.