肝静脈カテーテル法による肝循環動態に関する研究

第一篇臨床的研究

抄録

The auther has studied relationship between hepatic venous wedge pressure and hepatic venous catheterization method in the group of patients with heart disease or diabetes not accopanid by any evidence for hepatic parenchymal disease and also in the group of patients with hepatic disease. Following are the results and conclusion:
(1) Minimal positive correlation and negative correlation were found between hepatic venous wedge pressure (HVWP) and the ratio of effective hepatic blood flow to cardiac output (EHBF/CO) in the non-hepatic group and hepatic group, respectively. From these findings, in the non-hepatic group, HVWP appears to be proportional to the hepatic blood, flow, and in the hepatic group, the elevation of HVWP would be suggestive of the intrahepatic disorder of portal circulatory system, furthermore, indicative of increase in the intrahepatic vascular resistence.
(2) In the hepatic group, no significant correlation was found inbetween disappearance rate of BSP and EHBF/CO, meanwhile in the non-hepatic group, modest positive correlation was found inbetween these two parameters. In the non-hepatic group no significant correlation was found between disappearance rate and HVWP, while in the hepatic group modest negative correlation was found. These would imply that disappearance rate could be proportional to hepatic blood flow in the non-hepatic group, while in the hepatic group the decrease in disappearance rate could be indicative of hepatic parenchymal damage.
(3) Negative correlation between A-H BSP difference and EHBF/CO was significant in the hepatic group.Modest negative correlation was found in between A-H differenceand disappearance rate in the non-hepatic group, while no significant correlation in the hepatic group.Similarly minimal negative correlation was found inbetween A-H difference and HVWP in the non-hepatic group, and no significant correlation was found in the hepatic group.Although, in the hepatic group, if cases of acute hepatic disease are omitted, significant positive correlation was found. Therefore, generally speaking, reduction or increase in A-H difference would possibly be reflections of acceration or deceleration of hepatic blood flow rate.