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目的 探讨肝硬化体循环血流动力学变化、心脏病变及其发病机制。方法 肝硬化患者 2 7例 ,正常对照组 15例 ,按肝功能Child分级分类 ;应用超声Doppler检测体循环血流动力学、心脏收缩及舒张功能 (E波、A波、Ev/Av 比值 )。结果 与正常对照组相比 ,静息状态下肝功能B、C级肝硬化患者平均动脉压、外周阻力指数明显降低 (P<0 .0 5 ,P <0 .0 1)。肝功能A、B级患者心输出量、心脏指数、左室射血分数明显增加 (P <0 .0 5 ,P <0 .0 1) ,呈高动力循环状态 (P <0 .0 5 ,P <0 .0 1)。而肝功能C级患者心输出量、左室射血分数下降 ,提示心脏收缩功能损害。肝硬化患者Ev/Av 比值显著降低 (P <0 .0 1) ,示左室舒张功能不全。结论 晚期肝硬化患者存在肝硬化性心肌病
Objective To investigate the changes of hemodynamics and heart disease of cirrhosis and its pathogenesis. Methods Twenty-seven patients with cirrhosis and 15 normal controls were classified according to the classification of liver function. The hemodynamics, systolic and diastolic function (E wave, A wave and Ev / Av ratio) were measured by Doppler ultrasound. Results Compared with the normal control group, mean arterial pressure and peripheral resistance index of patients with liver function B and C cirrhosis at rest were significantly decreased (P <0.05, P <0.01). Cardiac output, cardiac index, and left ventricular ejection fraction were significantly increased in patients with liver function A and B (P <0.05, P <0.01), showing hyperdynamic circulation (P <0.05, P <0 .0 1). The C-class patients with liver function output, left ventricular ejection fraction decreased, suggesting that cardiac systolic dysfunction. Ev / Av ratio was significantly lower in patients with cirrhosis (P <0.01), showing left ventricular diastolic dysfunction. Conclusion There is cirrhotic cardiomyopathy in patients with advanced cirrhosis