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Журнал "Медицина невідкладних станів" Том 19, №6, 2023

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Методи оцінювання портальної гіпертензії

Автори: Чуклін С.М., Чуклін С.С.
Медичний центр Святої Параскеви, м. Львів, Україна

Рубрики: Медицина невідкладних станів

Розділи: Довідник фахівця

Версія для друку


Резюме

Багато дослідників і клініцистів вважають значення градієнта печінкового венозного тиску (ГПВТ) суттєвим прогностичним фактором у пацієнтів із хронічними захворюваннями печінки. Значення ГПВТ ≥ 10 мм рт.ст. визначають наявність клінічно значущої портальної гіпертензії (КЗПГ), основного предиктора ризику варикозної кровотечі, декомпенсації печінки та смертності. Однак вимірювання ГПВТ є інвазійним і вимагає значного досвіду, тому його рутинне використання за межами центрів третього рівня або клінічних випробувань обмежене. Клінічно значущу портальну гіпертензію також можна визначити за допомогою неінвазійних методів, як-от ультрасонографія, еластографія, магнітно-резонансна томографія та показники, отримані на підставі лабораторних параметрів. Наш огляд має на меті представити доцільність і застосовність ГВПТ у сучасній клінічній практиці у хворих на цироз печінки, включно з інвазійними та неінвазійними методами, на підставі літературних джерел з бази MedLine.

Many researchers and clinicians have taken the value of hepatic venous pressure gradient (HVPG) as an essential prognostic factor in subjects with chronic liver diseases. HVPG ≥ 10 mmHg indicates the presence of clinically significant portal hypertension, the main predictor of the risk of variceal bleeding, hepatic decompensation, and mortality. However, HVPG measurement is invasive and requires high expertise, so its routine use outside tertiary care centers or clinical trials is limited. Clinically significant portal hypertension also might be detected using non-invasive options such as ultrasonography, elastography, magnetic resonance imaging, and indices derived from laboratory parameters. Our review aims to present the feasibility and applicability of HVPG in modern clinical practice in patients with liver cirrhosis, including invasive and non-invasive methods, based on literary sources from the MEDLINE database.


Ключові слова

портальна гіпертензія; градієнт печінкового венозного тиску; клінічно значуща портальна гіпертензія; діагностика; огляд

portal hypertension; hepatic venous pressure gradient; clinically significant portal hypertension; diagnosis; review


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