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Abstract：
BACKGROUND: The liver is one of the most important organs in the human body, with functions such as detoxification, digestion, and blood coagulation. In terms of vascular anatomy, the liver is divided into the left and the right liver by the main portal vein, and there are three hepatic efferent veins (right, middle, and left) and two portal branches. Patients with impaired liver function have increased intrahepatic vascular resistance and splanchnic vasodilation, which may lead to an increase in the portal pressure gradient (PPG) and cause portal hypertension (PHT). In order to measure the increased pressure gradient of portal vein, the hepatic venous pressure gradient (HVPG) can be measured to reflect it in clinical practice. The accuracy of PPG measurements is directly related to patient prognosis.
OBJECTIVE: To analyze the correlation between HVPG of three hepatic veins and PPG in patients with PHT.
METHODS: From January 2017 to December 2019, 102 patients with PHT who met the inclusion criteria were evaluated during the transjugular intrahepatic portosystemic shunt procedure and analyzed.
RESULTS: The mean HVPG of the middle hepatic vein was 17.47 ± 10.25 mmHg, and the mean HVPG of the right and left hepatic veins was 16.34 ± 7.60 and 16.52 ± 8.15 mmHg, respectively. The average PPG was 26.03 ± 9.24 mmHg. The correlation coefficient and coefficient of determination of the right hepatic vein, middle hepatic vein, and left hepatic vein were 0.15 and 0.02 (P = 0.164); 0.25 and 0.05 (P = 0.013); and 0.14 and 0.02 (P = 0.013), respectively. The mean wedged hepatic vein/venous pressure (WHVP) of the middle and left hepatic veins was similar at 29.71 ± 12.48 and 29.1 ± 10.91 mmHg, respectively, and the mean WHVP of the right hepatic vein was slightly lower at 28.01 ± 8.95 mmHg. The mean portal vein pressure was 34.11 ± 8.56 mmHg. The correlation coefficient and coefficient of determination of the right hepatic vein, middle hepatic vein, and left hepatic vein were 0.26 and 0.07 (P = 0.009); 0.38 and 0.15 (P < 0.001); and 0.26 and 0.07 (P = 0.008), respectively. The average free hepatic venous pressure (FHVP) of the right hepatic vein was lowest at 11.67 ± 5.34 mmHg, and the average FHVP of the middle and left hepatic veins was slightly higher at 12.19 ± 4.88 and 11.67 ± 5.34 mmHg, respectively. The average inferior vena cava pressure was 8.27 ± 4.04 mmHg. The correlation coefficient and coefficient of determination of the right hepatic vein, middle hepatic vein, and left hepatic vein were 0.30 and 0.09 (P = 0.002); 0.18 and 0.03 (P = 0.078); and 0.16 and 0.03 (P = 0.111), respectively.
CONCLUSIONS: Measurement of the middle hepatic vein HVPG could better represent PPG. Considering the high success rate of clinical measurement of the right hepatic vein, it can be the second choice.
OBJECTIVE: To analyze the correlation between HVPG of three hepatic veins and PPG in patients with PHT.
METHODS: From January 2017 to December 2019, 102 patients with PHT who met the inclusion criteria were evaluated during the transjugular intrahepatic portosystemic shunt procedure and analyzed.
RESULTS: The mean HVPG of the middle hepatic vein was 17.47 ± 10.25 mmHg, and the mean HVPG of the right and left hepatic veins was 16.34 ± 7.60 and 16.52 ± 8.15 mmHg, respectively. The average PPG was 26.03 ± 9.24 mmHg. The correlation coefficient and coefficient of determination of the right hepatic vein, middle hepatic vein, and left hepatic vein were 0.15 and 0.02 (P = 0.164); 0.25 and 0.05 (P = 0.013); and 0.14 and 0.02 (P = 0.013), respectively. The mean wedged hepatic vein/venous pressure (WHVP) of the middle and left hepatic veins was similar at 29.71 ± 12.48 and 29.1 ± 10.91 mmHg, respectively, and the mean WHVP of the right hepatic vein was slightly lower at 28.01 ± 8.95 mmHg. The mean portal vein pressure was 34.11 ± 8.56 mmHg. The correlation coefficient and coefficient of determination of the right hepatic vein, middle hepatic vein, and left hepatic vein were 0.26 and 0.07 (P = 0.009); 0.38 and 0.15 (P < 0.001); and 0.26 and 0.07 (P = 0.008), respectively. The average free hepatic venous pressure (FHVP) of the right hepatic vein was lowest at 11.67 ± 5.34 mmHg, and the average FHVP of the middle and left hepatic veins was slightly higher at 12.19 ± 4.88 and 11.67 ± 5.34 mmHg, respectively. The average inferior vena cava pressure was 8.27 ± 4.04 mmHg. The correlation coefficient and coefficient of determination of the right hepatic vein, middle hepatic vein, and left hepatic vein were 0.30 and 0.09 (P = 0.002); 0.18 and 0.03 (P = 0.078); and 0.16 and 0.03 (P = 0.111), respectively.
CONCLUSIONS: Measurement of the middle hepatic vein HVPG could better represent PPG. Considering the high success rate of clinical measurement of the right hepatic vein, it can be the second choice.
摘要：
背景：肝脏是人体最重要的器官之一，具有排毒等功能，消化，和血液凝固。在血管解剖学方面，肝脏由主门静脉分为左肝和右肝，有三条肝流出静脉(右，中间,和左)和两个门户分支。肝功能受损的患者肝内血管阻力和内脏血管舒张增加，这可能导致门静脉压力梯度（PPG）增加并引起门静脉高压（PHT）。为了测量门静脉压力梯度的增加，可以测量肝静脉压力梯度（HVPG）以在临床实践中反映它。PPG测量的准确性与患者预后直接相关。
目的：分析PHT患者三肝静脉HVPG与PPG的相关性。
方法：2017年1月至2019年12月，在经颈静脉肝内门体分流术中评估并分析符合纳入标准的102例PHT患者。
结果：肝中静脉的平均HVPG为17.47±10.25mmHg，左右肝静脉的HVPG平均值为16.34±7.60和16.52±8.15mmHg，分别。平均PPG为26.03±9.24mmHg。右肝静脉的相关系数和决定系数，肝中静脉,左肝静脉分别为0.15和0.02（P=0.164）;0.25和0.05（P=0.013）;和0.14和0.02（P=0.013），分别。肝中静脉和左静脉的平均楔形肝静脉/静脉压（WHVP）相似，分别为29.71±12.48和29.1±10.91mmHg，分别,右肝静脉的平均WHVP略低，为28.01±8.95mmHg。平均门静脉压力为34.11±8.56mmHg。右肝静脉的相关系数和决定系数，肝中静脉,左肝静脉分别为0.26和0.07（P=0.009）;0.38和0.15（P<0.001）;和0.26和0.07（P=0.008），分别。右肝静脉的平均游离肝静脉压（FHVP）最低，为11.67±5.34mmHg，而肝中左静脉平均FHVP略高,分别为12.19±4.88和11.67±5.34mmHg,分别。下腔静脉平均压力为8.27±4.04mmHg。右肝静脉的相关系数和决定系数，肝中静脉,左肝静脉分别为0.30和0.09（P=0.002）;0.18和0.03（P=0.078）;和0.16和0.03（P=0.111），分别。
结论：测量肝中静脉HVPG可以更好地代表PPG。考虑到临床测量肝右静脉的成功率较高,它可能是第二选择。
目的：分析PHT患者三肝静脉HVPG与PPG的相关性。
方法：2017年1月至2019年12月，在经颈静脉肝内门体分流术中评估并分析符合纳入标准的102例PHT患者。
结果：肝中静脉的平均HVPG为17.47±10.25mmHg，左右肝静脉的HVPG平均值为16.34±7.60和16.52±8.15mmHg，分别。平均PPG为26.03±9.24mmHg。右肝静脉的相关系数和决定系数，肝中静脉,左肝静脉分别为0.15和0.02（P=0.164）;0.25和0.05（P=0.013）;和0.14和0.02（P=0.013），分别。肝中静脉和左静脉的平均楔形肝静脉/静脉压（WHVP）相似，分别为29.71±12.48和29.1±10.91mmHg，分别,右肝静脉的平均WHVP略低，为28.01±8.95mmHg。平均门静脉压力为34.11±8.56mmHg。右肝静脉的相关系数和决定系数，肝中静脉,左肝静脉分别为0.26和0.07（P=0.009）;0.38和0.15（P<0.001）;和0.26和0.07（P=0.008），分别。右肝静脉的平均游离肝静脉压（FHVP）最低，为11.67±5.34mmHg，而肝中左静脉平均FHVP略高,分别为12.19±4.88和11.67±5.34mmHg,分别。下腔静脉平均压力为8.27±4.04mmHg。右肝静脉的相关系数和决定系数，肝中静脉,左肝静脉分别为0.30和0.09（P=0.002）;0.18和0.03（P=0.078）;和0.16和0.03（P=0.111），分别。
结论：测量肝中静脉HVPG可以更好地代表PPG。考虑到临床测量肝右静脉的成功率较高,它可能是第二选择。
