RESUMO
Portal pressure (PP) was studied in 64 patients with chronic viral hepatitis (CVH) type B and C; Doppler ultrasonography and a special empiric formula of PP calculation, the reliability of which was confirmed by the results of invasive splenoportometry, were applied. The control group consisted of 40 practically healthy individuals. In the healthy PP was 11.3 +/- 0.44 mbar; in patients with minimal activity of CVH-- 12.005 +/- 0.739 mbar (p > 0.05), in patients with moderate CVH activity-- 16.704 +/- 1.416 mbar; in patients with high CVH activity-- 19.326 +/- 1.048 mbar (p < 0.05). The results show that CVH leads to portal hypertension, the degree of which depends on the activity of the inflammatory process in the liver. In 37 patients PP was measured after a course of complex therapy; despite positive clinical changes, the degree of PP only tended to lower. Prolonged (3 years) follow-up of 21 patients with CVH revealed that most of them had increased PP and dilatation of portal and splenic veins, which is a sign of a gradual progression of the disease.
Assuntos
Hepatite Crônica/complicações , Hipertensão Portal , Ultrassonografia Doppler/métodos , Adulto , Biópsia , Feminino , Hemodinâmica/fisiologia , Hepatite Crônica/patologia , Humanos , Hipertensão Portal/complicações , Hipertensão Portal/diagnóstico por imagem , Hipertensão Portal/fisiopatologia , Fígado/patologia , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de DoençaRESUMO
Combined investigations have shown that the pulmonary syndrome in chronic liver diseases is a group of changes (heterogeneous in their structure and origin), most of which are of intercurrent nature (chronic bronchitis and its complications, chronic pneumonia), the lesser part of them is related directly to an inflammatory liver process and constitutes the true pulmonary syndrome (interstitial pneumonitis, fibrosing alveolitis). In view of the fact that chronic liver pathology is attended by concomitant disorders of pulmonary ventilation, hemodynamics and immunologic homestasis, the authors propose that they should be regarded as a risk factor contributing to the development of respiratory diseases.
