Central and nonsplanchnic hemodynamic changes in liver cirrhosis

Dinç DİNÇER,Fatih BEŞIŞIK,Onur DEMİRKOL,Kemal DEMİR,Sabahattin KAYMAKOĞLU,Yılmaz ÇAKALOĞLU,Atilla ÖKTEN

Abstract

: In this study, central and nonsplanchnic hemodynamic changes in liver cirrhosis and correlation between stages of the disease and these hemodynamic changes were evaluated. With this aim, angiotensin I, aldosteron, femoral blood flow, cardiac index, free water clearance and renal blood flow index were evaluated in 30 cirrhotic patients (8 patients were in Child group A, 11 in Child B and 11 in Child C) and'healthy control subjects. Also, correlation between these parameters were evaluated. Child-Pugh score was directly correlated with angiotensin I, aldosterone, cardiac index, renal blood flow index (r=0.60, p<0.001; r=O.B7, p<0.01; r=0.5B, p<0.01 and r-0.65, p<0.001 respectively), and indirectly correlated with free water clearance and femoral blood flow (r=0.72, p<0.001 and r=0.71, p<0.001 respectively). There was an indirect correlation between the amount of ascites and angiotensin I and aldosterone (r=0.82, p<0.001 and r=0.56, p<0.01 respectively). Cardiac index was directly correlated with angiotensin I and aldosterone (r=0.49, p<0.01 and r=0.62, p<0.001 respectively). There were no significant differences in angiotensin I, aldosterone, free water clearance and renal blood flow index between the healthy control subjects and Child A group (p>0.05), but femoral blood flow and cardiac index were significantly increased in Child A group (p<0.01 and p<0.001 respectively). We concluded that these hemodynamic parameters can be helpful in evaluating the prognosis of liver cirrhosis.

Özet

Bu çalışmada karaciğer sirozlu hastalarda meydana gelen santral ve nonsplanknik hemodinamik değişiklikler ve bu değişikliklerin hastalığın evresi ile olan ilişkisi ortaya konulmaya çalışıldı. Bu amaçla, karaciğer sirozu tanısı konulmuş 30 hasta Child-Pugh sınıflamasına göre ayrıldı (8 hasta Child A, 11 hasta Child B, 11 hasta Child C grubunda olarak) ve 10 adet sağlıklı kontrol vakası ile birlikte anjiotensin I, aldosteron, femoral arter kan akımı, kardiyak indeks, serbest su klirensi ve renal akım indeksleri ölçüldü. Ayrıca bu parametrelerin birbirleriyle olan ilişkisi de araştırıldı. Child-Pugh skoru anjiotensin I, aldosteron, kardiyak indeks ve renal akım indeksi ile uyumlu iken (sırasıyla r=0.60, p 0.06), femoral arter kan akımı ve kardiyak indeks Child A grubunda anlamlı olarak artmaktaydı. Sonuç olarak, karaciğer sirozunda bu parametrelerin hastalığın prognozunu saptamada yararlı olabileceği düşünülmüştür.