Abstract：
OBJECTIVE: This study aims to evaluate the differences between The balloon catheter method and End-hole Catheter Method in measuring hepatic venous pressure gradient (HVPG) among cirrhosis patients.
METHODS: From October 2017 to January 2024, patients who underwent HVPG measurements using both methods were consecutively included. HVPGs obtained from both methods were compared with the portal vein pressure gradient (PPG) obtained via transjugular intrahepatic portosystemic shunt (TIPS) using paired comparisons. Additionally, the consistency and predictive ability for bleeding risk of the two methods, as well as the impact of intrahepatic veno-venous shunt (IHVS), were analyzed.
RESULTS: The study enrolled 145 patients, each of whom had HVPG measured by both methods. PPG was measured in 61 patients. There was a statistically significant difference between the PPGs and HVPGs measured by both the balloon catheter method and the end-hole catheter method (P < 0.001), with the HVPG mean values obtained by the end-hole catheter method being closer to the PPGs. In the non-IHVS group, no significant statistical difference was found between the two methods (P = 0.071). In contrast, the IHVS group showed a significant difference (P < 0.001), with a mean difference of 2.98 ± 4.03 mmHg. When IHVS was absent, the measurement results from the end-hole catheter method and the balloon catheter method were found to be highly correlated. The end-hole catheter method has a higher screening capability for patients at risk of bleeding compared to the balloon catheter method (75.90% vs. 72.86%).
CONCLUSIONS: HVPG measurements using either the balloon catheter method or end-hole catheter method showed significant difference with the PPG. The end-hole catheter method has a higher screening capability for patients at risk of bleeding, and IHVS could lead to lower HVPG measurements with The balloon catheter method.
METHODS: From October 2017 to January 2024, patients who underwent HVPG measurements using both methods were consecutively included. HVPGs obtained from both methods were compared with the portal vein pressure gradient (PPG) obtained via transjugular intrahepatic portosystemic shunt (TIPS) using paired comparisons. Additionally, the consistency and predictive ability for bleeding risk of the two methods, as well as the impact of intrahepatic veno-venous shunt (IHVS), were analyzed.
RESULTS: The study enrolled 145 patients, each of whom had HVPG measured by both methods. PPG was measured in 61 patients. There was a statistically significant difference between the PPGs and HVPGs measured by both the balloon catheter method and the end-hole catheter method (P < 0.001), with the HVPG mean values obtained by the end-hole catheter method being closer to the PPGs. In the non-IHVS group, no significant statistical difference was found between the two methods (P = 0.071). In contrast, the IHVS group showed a significant difference (P < 0.001), with a mean difference of 2.98 ± 4.03 mmHg. When IHVS was absent, the measurement results from the end-hole catheter method and the balloon catheter method were found to be highly correlated. The end-hole catheter method has a higher screening capability for patients at risk of bleeding compared to the balloon catheter method (75.90% vs. 72.86%).
CONCLUSIONS: HVPG measurements using either the balloon catheter method or end-hole catheter method showed significant difference with the PPG. The end-hole catheter method has a higher screening capability for patients at risk of bleeding, and IHVS could lead to lower HVPG measurements with The balloon catheter method.
摘要：
目的：本研究旨在评估球囊导管方法和端孔导管方法在肝硬化患者中测量肝静脉压力梯度（HVPG）的差异。
方法：从2017年10月至2024年1月，连续纳入使用两种方法进行HVPG测量的患者。使用配对比较将从两种方法获得的HVPG与通过经颈静脉肝内门体分流术（TIPS）获得的门静脉压力梯度（PPG）进行比较。此外,两种方法对出血风险的一致性和预测能力，以及肝内静脉-静脉分流（IHVS）的影响，进行了分析。
结果：该研究招募了145名患者，每个人都有通过两种方法测量的HVPG。在61例患者中测量PPG。球囊导管法和端孔导管法测得的PPGs和HVPGs在统计学上有显著差异(P<0.001),通过端孔导管方法获得的HVPG平均值更接近PPG。在非IHVS组中，两种方法比较差异无统计学意义(P=0.071)。相比之下,IHVS组差异有统计学意义(P<0.001),平均差为2.98±4.03mmHg。当IHVS缺席时，发现端孔导管法和球囊导管法的测量结果高度相关。与球囊导管方法相比，端孔导管方法对有出血风险的患者具有更高的筛查能力（75.90%vs.72.86%）。
结论：使用球囊导管法或端孔导管法进行的HVPG测量与PPG有显著差异。端孔导管方法对有出血风险的患者具有更高的筛查能力，和HVS可能导致较低的HVPG测量与球囊导管方法。
方法：从2017年10月至2024年1月，连续纳入使用两种方法进行HVPG测量的患者。使用配对比较将从两种方法获得的HVPG与通过经颈静脉肝内门体分流术（TIPS）获得的门静脉压力梯度（PPG）进行比较。此外,两种方法对出血风险的一致性和预测能力，以及肝内静脉-静脉分流（IHVS）的影响，进行了分析。
结果：该研究招募了145名患者，每个人都有通过两种方法测量的HVPG。在61例患者中测量PPG。球囊导管法和端孔导管法测得的PPGs和HVPGs在统计学上有显著差异(P<0.001),通过端孔导管方法获得的HVPG平均值更接近PPG。在非IHVS组中，两种方法比较差异无统计学意义(P=0.071)。相比之下,IHVS组差异有统计学意义(P<0.001),平均差为2.98±4.03mmHg。当IHVS缺席时，发现端孔导管法和球囊导管法的测量结果高度相关。与球囊导管方法相比，端孔导管方法对有出血风险的患者具有更高的筛查能力（75.90%vs.72.86%）。
结论：使用球囊导管法或端孔导管法进行的HVPG测量与PPG有显著差异。端孔导管方法对有出血风险的患者具有更高的筛查能力，和HVS可能导致较低的HVPG测量与球囊导管方法。
