Changes Porto-hepatic Blood Flow in Patients with Cirrhosis of the Liver, Combined with Chronic Bronchitis

Abstract

The objective: study the features of porto1hepatic blood flow in patients with alcoholic liver cirrhosis (ALC) in conjunction with chronic bronchitis (CB) according to Doppler ultrasound.
 Patients and methods. The study involved 60 patients who were hospitalized, 20 ALC patients in stage B according to Child-Pugh without CB (Ist group), 20 ALC patients in stage B according to Child-Pugh combined with CB in the acute phase (IInd group), 20 patients exacerbation of chronic bronchitis, for which there was no evidence of digestive system diseases (IIIrd group). All patients underwent a complex ultrasonic research techniques scanning in B-mode, the VD-mode, color duplex scanning using «Hitachi EUB 7000» ultrasonic scanner connected to the Doppler flourimetr was visualized main arterial and venous vessels of hepatic and splenic pools.
 Results. Changes porto-hepatic blood flow were most pronounced in patients with ALC in combination with CB when compared with patients of groups I and III (p<0,05) according to the obtained Doppler indices: diameter of the hepatic artery was 5,55±0,19 mm, portal vein – 12,60±0,17 mm, where increased by 159,12% and 53,56%, respectively (p<0,05) higher than those in healthy individuals.
 The diameter of the splenic artery and splenic vein at the ALC for combination with CB significantly increased compared with control on 31,13% and 35,67%, respectively (p<0,05).
 Linear and volumetric blood flow rate in portal vein decreased in this group of patients, 60,24% and 22,68%, respectively (p<0,05) compared with healthy individuals, the linear velocity of blood flow in the splenic vein also significantly slowed down compared to the control on 41,06% (p<0,05), and the volumetric blood flow velocity v. lienalis grew by 155,80% (p<0,05).
 Among the characteristics of the arterial blood flow hepato-splenic system Gosling pulsatility index (PI) and Pursello resistance index (RI) of hepatic artery also Pursello resistance index (RI) of splenic artery significantly grew in ALC patients in combination with CB 147,20%, 65,49% and 32,31%, respectively (p<0,05) compared with the control group.
 Maximal systolic velocity of blood flow in the hepatic artery of patients – grew by 8,95% (p<0,05). End diastolic blood flow velocity in the hepatic artery tended to decrease on 13,36% (p<0,05) compared with healthy individuals.
 Conclusion. Violation of porto-hepatic blood flow in patients with ALC is characterized by its redistribution in the veins of the portal system in the direction of the spleen with a decrease in the average linear and the volumetric velocity in the portal and hepatic veins, increasing the resistance index in the interlobar arteries.