Abstract
We investigated the distribution of portal blood flow per kilogram body weight (PBF/BW) in 112 healthy volunteers and 90 patients with liver cirrhosis using an ultrasonic Doppler duplex system. The PBF/BW in healthy volunteers showed a log-normal distribution, while the distribution was irregular and showed two peaks in patients with cirrhosis. This irregular distribution was thought to reflect the complex physiopathologic condition of patients with cirrhosis.
We analyzed the relationship between PBF/BW and the data from hepatic function tests (serum albumin, total bilirubin, ICG 15-min retention rate and ICG plasma disappearance rate) in 48 patients with liver cirrhosis. Patients were divided into four groups; group A with a hepatofugal or stagnant portal blood flow, group B with a hepatopetal PBF/BW of less than 12ml/min/kg, group C with a hepatopetal PBF/BW of 12 or more but less than 20ml/min/kg, and group D with a hepatopetal PBF/BW of 20ml/min/kg or more. Group A showed the worst results in hepatic function tests, group D the second worst, and group C the best. The effective heaptic blood flow (EHBF) was thought to have decreased because of the development of extrahepatic portasystemic shunts in the patients in group A, and EHBF to have decreased because of the development of intrahepatic shunts in patients in group D. The results of hepatic function tests deteriorated as a consequence of the decrease in EHBF.
