AIM: To elucidate the natural history and the longitudinal outcomes in cirrhotic patients with non-forward portal flow(NFPF).METHODS: The present retrospective study consisted of 222 cirrhotic patients(120 males and 1...AIM: To elucidate the natural history and the longitudinal outcomes in cirrhotic patients with non-forward portal flow(NFPF).METHODS: The present retrospective study consisted of 222 cirrhotic patients(120 males and 102 females; age, 61.7 ± 11.1 years). The portal hemodynamics were evaluated at baseline and during the observation period using both pulsed and color Doppler ultrasonography. The diameter(mm), flow direction, mean flow velocity(cm/s), and mean flow volume(m L/min) were assessed at the portal trunk, the splenic vein, the superior mesenteric vein, and the collateral vessels. The average values from 2 to 4 measurements were used for the data analysis. The portal flow direction was defined as follows: forward portal flow(FPF) for continuous hepatopetal flow; bidirectional flow for to-and-fro flow; and reversed flow for continuous hepatofugal flow. The bidirectional flow and the reversed flow were classified as NFPF in this study. The clinical findings and prognosis were compared between the patients with FPF and those with NFPF. The median follow-up period was 40.9 mo(range, 0.3-156.5 mo).RESULTS: Twenty-four patients(10.8%) demonstrated NFPF, accompanied by lower albumin level, worse ChildPugh scores, and model for end-stage liver disease scores. The portal hemodynamic features in the patients with NFPF were smaller diameter of the portal trunk;presence of short gastric vein, splenorenal shunt, or inferior mesenteric vein; and advanced collateral vessels(diameter > 8.7 mm, flow velocity > 10.2 cm/s, and flow volume > 310 m L/min). The cumulative incidence rates of NFPF were 6.5% at 1 year, 14.5% at 3 years, and 23.1% at 5 years. The collateral vessels characterized by flow velocity > 9.5 cm/s and those located at the splenic hilum were significant predictive factors for developing NFPF. The cumulative survival rate was significantly lower in the patients with NFPF(72.2% at 1 year, 38.5% at 3 years, 38.5% at 5 years) than in those with forward portal flow(84.0% at 1 year, 67.8% at 3 years, 54.3% at 5 ye展开更多
目的探讨柔肝化纤颗粒联合核苷类抗病毒药物对乙型肝炎失代偿期肝硬化患者肝肾功能、门静脉系统血流动力学、血管活性、抗病毒指标及对天冬氨酸氨基转移酶-血小板比值指数(aspartate aminotransferase-platelet ratio index,APRI)的影...目的探讨柔肝化纤颗粒联合核苷类抗病毒药物对乙型肝炎失代偿期肝硬化患者肝肾功能、门静脉系统血流动力学、血管活性、抗病毒指标及对天冬氨酸氨基转移酶-血小板比值指数(aspartate aminotransferase-platelet ratio index,APRI)的影响。方法采用病例对照研究方法,收集2017年6月至2019年12月于唐山市传染病院和华北理工大学附属医院住院的乙型肝炎失代偿期肝硬化患者150例。应用计算机随机数字法分为对照组和观察组,每组各75例。对照组给予常规护肝和抗病毒治疗;观察组在对照组治疗的基础上加用柔肝化纤颗粒。观察两组患者的肝肾功能、门静脉系统血流动力学、血管活性、抗病毒指标及对APRI的变化。计量资料的两组间比较采用独立样本t检验,同组间治疗前后比较采用配对t检验,计数资料采用χ^(2)检验。结果两组患者性别、年龄、肝硬化病程、肝功能Child分级、治疗前各项指标基数资料比较差异均无统计学意义(均P>0.05)。治疗后两组患者丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、门静脉内径(diameter of portal vein,Dpv)、脾静脉内径(diameter of splenic vein,Dsv)、内皮素1、一氧化氮、胰高血糖素(glucagon,GLA)、APRI均较治疗前降低;组间比较,观察组ALT(51.60±15.97)U/L、AST(62.65±26.28)U/L、尿素氮(10.25±1.65)mmol/L、肌酐(78.54±14.09)μmol/L、Dpv(10.20±1.10)mm、Dsv(8.08±0.68)mm、内皮素1(31.93±6.35)ng/L、一氧化氮(41.38±8.06)μg/L、GLA(69.54±12.14)mg/L、APRI 3.14±1.35明显低于对照组[(97.49±30.87)U/L、(96.03±25.63)U/L、(17.49±2.55)mmol/L、(116.43±22.77)μmol/L、(13.42±1.26)mm、(10.44±0.83)mm、(44.34±11.88)ng/L、(63.47±15.50)μg/L、(107.11±25.29)mg/L、5.91±1.93],差异均有统计学意义(t值分别为11.43、7.87、20.64、12.26、16.62、18.99、7.98、10.96、11.60、10.23,均P<0.05)。治疗后两组展开更多
To examine the role and effect of nitric oxide synthase type Ⅱ(NOSⅡ) in cirrhotic rats, expression of NOSⅡ mRNA was detected by real time RT-PCR. The enzymatic activity of nitric oxide synthase and the circulating ...To examine the role and effect of nitric oxide synthase type Ⅱ(NOSⅡ) in cirrhotic rats, expression of NOSⅡ mRNA was detected by real time RT-PCR. The enzymatic activity of nitric oxide synthase and the circulating levels of NO, systemic and portal hemodynamics and quantification of cirrhosis were measured. Chinese traditional medicine was used to treat cirrhotic rats and the effect of NO was evaluated. Double-blind method was used in experiment. Our results showed the concentration of NO and the enzymatic activity of NOS increased markedly at all stages of cirrhosis and iNOSmRNA was strongly expressed. Meanwhile, the portal-venous-pressure (PVP) and portal-venous-flow (PVF) were significantly increased. NO, NOS and iNOSmRNA were positively correlated to the degree of hepatic fibrosis. Tetrandrine significantly inhibited NO production and the expression of iNOSmRNA. Our results suggested that increased hepatic expression of NOSⅡ is one of the important factors causing cirrhosis and portal hypertension. Tetrandrine can significantly ameliorate cirrhosis and portal hypertension.展开更多
OBJECTIVE: To determine the effect of Salviae miltiorrhizae on cirrhosis and portal hyperiension by inhibiting nitric oxide synthase type Ⅱ (NOSⅡ) in rats. METHODS: Real time RT-PCR was used to detect the expression...OBJECTIVE: To determine the effect of Salviae miltiorrhizae on cirrhosis and portal hyperiension by inhibiting nitric oxide synthase type Ⅱ (NOSⅡ) in rats. METHODS: Real time RT-PCR was used to detect the expression of NOSII mRNA. The enzymatic activity of nitric oxide synthase and the circulating levels of nitric oxide (NO), systemic and portal hemodynamics, and quantification of cirrhosis were measured with highly sensitive methods. Traditional Chinese medicine was utilized to treat cirrhotic rats and the function of NO was evaluated. Double-blind method was applied in the experiment constantly. RESULTS: The concentration of NO increased markedly at all stages of cirrhosis, and so did the enzymatic activity of NOS, antl the iNOSmRNA expressed greatly. Meanwhile the portal-venous-pressure (PVP), portal-venous-now (PVF) increased significantly. NO, Nos and iNOSmHNA were positively correlated to the quanlity of hepatic fihrosis. Salviae Miltiorrhizae significantly inhibited NO production and inhibited the expression of iNOSmRNA. CONCLUSIONS: The increased hepatic expression of NoSIⅡ is one of the important factors causing cirrhosis and portal hypertension. Salviae Miltiorrhizae significantly ameliorates cirrhosis and portal hypertension.展开更多
文摘AIM: To elucidate the natural history and the longitudinal outcomes in cirrhotic patients with non-forward portal flow(NFPF).METHODS: The present retrospective study consisted of 222 cirrhotic patients(120 males and 102 females; age, 61.7 ± 11.1 years). The portal hemodynamics were evaluated at baseline and during the observation period using both pulsed and color Doppler ultrasonography. The diameter(mm), flow direction, mean flow velocity(cm/s), and mean flow volume(m L/min) were assessed at the portal trunk, the splenic vein, the superior mesenteric vein, and the collateral vessels. The average values from 2 to 4 measurements were used for the data analysis. The portal flow direction was defined as follows: forward portal flow(FPF) for continuous hepatopetal flow; bidirectional flow for to-and-fro flow; and reversed flow for continuous hepatofugal flow. The bidirectional flow and the reversed flow were classified as NFPF in this study. The clinical findings and prognosis were compared between the patients with FPF and those with NFPF. The median follow-up period was 40.9 mo(range, 0.3-156.5 mo).RESULTS: Twenty-four patients(10.8%) demonstrated NFPF, accompanied by lower albumin level, worse ChildPugh scores, and model for end-stage liver disease scores. The portal hemodynamic features in the patients with NFPF were smaller diameter of the portal trunk;presence of short gastric vein, splenorenal shunt, or inferior mesenteric vein; and advanced collateral vessels(diameter > 8.7 mm, flow velocity > 10.2 cm/s, and flow volume > 310 m L/min). The cumulative incidence rates of NFPF were 6.5% at 1 year, 14.5% at 3 years, and 23.1% at 5 years. The collateral vessels characterized by flow velocity > 9.5 cm/s and those located at the splenic hilum were significant predictive factors for developing NFPF. The cumulative survival rate was significantly lower in the patients with NFPF(72.2% at 1 year, 38.5% at 3 years, 38.5% at 5 years) than in those with forward portal flow(84.0% at 1 year, 67.8% at 3 years, 54.3% at 5 ye
文摘目的探讨柔肝化纤颗粒联合核苷类抗病毒药物对乙型肝炎失代偿期肝硬化患者肝肾功能、门静脉系统血流动力学、血管活性、抗病毒指标及对天冬氨酸氨基转移酶-血小板比值指数(aspartate aminotransferase-platelet ratio index,APRI)的影响。方法采用病例对照研究方法,收集2017年6月至2019年12月于唐山市传染病院和华北理工大学附属医院住院的乙型肝炎失代偿期肝硬化患者150例。应用计算机随机数字法分为对照组和观察组,每组各75例。对照组给予常规护肝和抗病毒治疗;观察组在对照组治疗的基础上加用柔肝化纤颗粒。观察两组患者的肝肾功能、门静脉系统血流动力学、血管活性、抗病毒指标及对APRI的变化。计量资料的两组间比较采用独立样本t检验,同组间治疗前后比较采用配对t检验,计数资料采用χ^(2)检验。结果两组患者性别、年龄、肝硬化病程、肝功能Child分级、治疗前各项指标基数资料比较差异均无统计学意义(均P>0.05)。治疗后两组患者丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、门静脉内径(diameter of portal vein,Dpv)、脾静脉内径(diameter of splenic vein,Dsv)、内皮素1、一氧化氮、胰高血糖素(glucagon,GLA)、APRI均较治疗前降低;组间比较,观察组ALT(51.60±15.97)U/L、AST(62.65±26.28)U/L、尿素氮(10.25±1.65)mmol/L、肌酐(78.54±14.09)μmol/L、Dpv(10.20±1.10)mm、Dsv(8.08±0.68)mm、内皮素1(31.93±6.35)ng/L、一氧化氮(41.38±8.06)μg/L、GLA(69.54±12.14)mg/L、APRI 3.14±1.35明显低于对照组[(97.49±30.87)U/L、(96.03±25.63)U/L、(17.49±2.55)mmol/L、(116.43±22.77)μmol/L、(13.42±1.26)mm、(10.44±0.83)mm、(44.34±11.88)ng/L、(63.47±15.50)μg/L、(107.11±25.29)mg/L、5.91±1.93],差异均有统计学意义(t值分别为11.43、7.87、20.64、12.26、16.62、18.99、7.98、10.96、11.60、10.23,均P<0.05)。治疗后两组
文摘To examine the role and effect of nitric oxide synthase type Ⅱ(NOSⅡ) in cirrhotic rats, expression of NOSⅡ mRNA was detected by real time RT-PCR. The enzymatic activity of nitric oxide synthase and the circulating levels of NO, systemic and portal hemodynamics and quantification of cirrhosis were measured. Chinese traditional medicine was used to treat cirrhotic rats and the effect of NO was evaluated. Double-blind method was used in experiment. Our results showed the concentration of NO and the enzymatic activity of NOS increased markedly at all stages of cirrhosis and iNOSmRNA was strongly expressed. Meanwhile, the portal-venous-pressure (PVP) and portal-venous-flow (PVF) were significantly increased. NO, NOS and iNOSmRNA were positively correlated to the degree of hepatic fibrosis. Tetrandrine significantly inhibited NO production and the expression of iNOSmRNA. Our results suggested that increased hepatic expression of NOSⅡ is one of the important factors causing cirrhosis and portal hypertension. Tetrandrine can significantly ameliorate cirrhosis and portal hypertension.
文摘OBJECTIVE: To determine the effect of Salviae miltiorrhizae on cirrhosis and portal hyperiension by inhibiting nitric oxide synthase type Ⅱ (NOSⅡ) in rats. METHODS: Real time RT-PCR was used to detect the expression of NOSII mRNA. The enzymatic activity of nitric oxide synthase and the circulating levels of nitric oxide (NO), systemic and portal hemodynamics, and quantification of cirrhosis were measured with highly sensitive methods. Traditional Chinese medicine was utilized to treat cirrhotic rats and the function of NO was evaluated. Double-blind method was applied in the experiment constantly. RESULTS: The concentration of NO increased markedly at all stages of cirrhosis, and so did the enzymatic activity of NOS, antl the iNOSmRNA expressed greatly. Meanwhile the portal-venous-pressure (PVP), portal-venous-now (PVF) increased significantly. NO, Nos and iNOSmHNA were positively correlated to the quanlity of hepatic fihrosis. Salviae Miltiorrhizae significantly inhibited NO production and inhibited the expression of iNOSmRNA. CONCLUSIONS: The increased hepatic expression of NoSIⅡ is one of the important factors causing cirrhosis and portal hypertension. Salviae Miltiorrhizae significantly ameliorates cirrhosis and portal hypertension.
