TANG Libin, GU Xiaoli, HE Weiyaozhen, QI Fei, XIA Jiawei, LI Haiwen. Influencing factors of liver cirrhosis patients complicated with hepatopulmonary syndrome and diagnostic value of contrast echocardiography of right heart[J]. Journal of Clinical Medicine in Practice, 2022, 26(18): 11-15, 20. DOI: 10.7619/jcmp.20220470
Citation: TANG Libin, GU Xiaoli, HE Weiyaozhen, QI Fei, XIA Jiawei, LI Haiwen. Influencing factors of liver cirrhosis patients complicated with hepatopulmonary syndrome and diagnostic value of contrast echocardiography of right heart[J]. Journal of Clinical Medicine in Practice, 2022, 26(18): 11-15, 20. DOI: 10.7619/jcmp.20220470

Influencing factors of liver cirrhosis patients complicated with hepatopulmonary syndrome and diagnostic value of contrast echocardiography of right heart

More Information
  • Received Date: February 15, 2022
  • Available Online: October 23, 2022
  • Objective 

    To analyze the influencing factors of liver cirrhosis patients complicated with hepatopulmonary syndrome (HPS) and diagnostic value of contrast echocardiography of right heart.

    Methods 

    A total of 286 patients diagnosed as liver cirrhosis and meeting the screening criteria from July 2019 to February 2021 were selected as research objects. Indicators of blood routine, liver function, renal function, coagulation function, endothelin-1 (ET-1) and tumor necrosis factor-α (TNF-α) levels were detected in all patients within 3 days before right cardiography examination were detected, and the diagnostic sensitivity and adverse reactions of right phonography for HPS were observed. Incidence and risk factors of HPS were analyzed, and the correlations of semi-quantitative microbubble volume with the severity of HPS, liver function, ET-1 and TNF-α were analyzed.

    Results 

    Of 286 patients with liver cirrhosis in this study, 36 cases were positive in contrast echocardiography of right heart, and 32 cases were clinically diagnosed as HPS. Univariate analysis and multifactor Logistic regression analysis showed that grade C of Child-Pugh classification, D-dimer, ET-1 and TNF-α were the risk factors for HPS (P < 0.05). In 32 patients with HPS, 17 cases had small amount of microbubbles, 10 cases had medium amount of microbubbles, and 5 cases had large amount of microbubbles. The number of microbubbles in contrast echocardiography of right heart was positively correlated with HPS classification and serum ET-1 (P < 0.01).

    Conclusion 

    Grade C of Child-Pugh classification and high levels of D-dimer, ET-1 and TNF-α are the risk factors for HPS in liver cirrhosis patients. Contrast echocardiography of right heart has a high sensitivity in the diagnosis of HPS, and the semi-quantitative determination of contrast echocardiography of right heart can predict the severity of HPS.

  • [1]
    TUMGOR G. Cirrhosis and hepatopulmonary syndrome[J]. World J Gastroenterol, 2014, 20(10): 2586-2594. doi: 10.3748/wjg.v20.i10.2586
    [2]
    蔡均均, 张倩, 韩涛. 肝肺综合征的诊治对策[J]. 中华肝脏病杂志, 2020, 28(5): 386-390. doi: 10.3760/cma.j.cn501113-20200424-00211
    [3]
    GRILO-BENSUSAN I, PASCASIO-ACEVEDO J M. Hepatopulmonary syndrome: what we know and what we would like to know[J]. World J Gastroenterol, 2016, 22(25): 5728-5741. doi: 10.3748/wjg.v22.i25.5728
    [4]
    VILLA E, FATTOVICH G, MAURO A, et al. Natural history of chronic HBV infection: special emphasis on the prognostic implications of the inactive carrier state versus chronic hepatitis[J]. Dig Liver Dis, 2011, 43(Suppl 1): S8-S14.
    [5]
    KROWKA M J, FALLON M B, KAWUT S M, et al. International liver transplant society practice guidelines: diagnosis and management of hepatopulmonary syndrome and portopulmonary hypertension[J]. Transplantation, 2016, 100(7): 1440-1452. doi: 10.1097/TP.0000000000001229
    [6]
    中华医学会感染病学分会, 中华医学会肝病学分会. 慢性乙型肝炎防治指南(2019年版)[J]. 中华传染病杂志, 2019, 37(12): 711-736. doi: 10.3760/cma.j.issn.1000-6680.2019.12.003
    [7]
    中华医学会肝病学分会脂肪肝和酒精性肝病学组, 中国医师协会脂肪性肝病专家委员会. 酒精性肝病防治指南(2018年更新版)[J]. 临床肝胆病杂志, 2018, 34(5): 939-946. doi: 10.3969/j.issn.1001-5256.2018.05.006
    [8]
    中华医学会感染病学分会, 中华医学会肝病学分会. 慢性乙型肝炎防治指南(2019年版)[J]. 中华肝脏病杂志, 2019, 27(12): 938-961. doi: 10.3760/cma.j.issn.1007-3418.2019.12.007
    [9]
    RODRÍGUEZ-ROISIN R, KROWKA M J. Hepatopulmonary syndrome: a liver-induced lung vascular disorder[J]. N Engl J Med, 2008, 358(22): 2378-2387. doi: 10.1056/NEJMra0707185
    [10]
    IQBAL S, SMITH K A, KHUNGAR V. Hepatopulmonary syndrome and portopulmonary hypertension: implications for liver transplantation[J]. Clin Chest Med, 2017, 38(4): 785-795. doi: 10.1016/j.ccm.2017.08.002
    [11]
    SHARMA N S, WILLE K M, DIAZ GUZMAN E. Extracorporeal membrane oxygenation after liver transplantation in a patient with hepatopulmonary syndrome and an atrial septal defect[J]. Int J Artif Organs, 2015, 38(3): 170-172. doi: 10.5301/ijao.5000399
    [12]
    李梅. 肝肺综合征的超声影像学研究进展[J]. 实用心脑肺血管病杂志, 2011, 19(6): 1060-1061. doi: 10.3969/j.issn.1008-5971.2011.06.120
    [13]
    刘以俊, 李涛. 《2016年国际肝移植学会实践指南: 肝肺综合征与门脉性肺动脉高压的诊断与管理》摘译[J]. 临床肝胆病杂志, 2016, 32(10): 1838-1842. doi: 10.3969/j.issn.1001-5256.2016.10.002
    [14]
    谭年花, 陈斌. 慢加亚急性肝衰竭大鼠肠源性内毒素血症时Th17/Treg表达变化的实验研究[J]. 湖南中医杂志, 2019, 35(3): 134-138. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZO201903063.htm
    [15]
    RAEVENS S, FALLON M B. Potential clinical targets in hepatopulmonary syndrome: lessons from experimental models[J]. Hepatology, 2018, 68(5): 2016-2028. doi: 10.1002/hep.30079
    [16]
    RAEVENS S, GEERTS A, VAN STEENKISTE C, et al. Hepatopulmonary syndrome and portopulmonary hypertension: recent knowledge in pathogenesis and overview of clinical assessment[J]. Liver Int, 2015, 35(6): 1646-1660. doi: 10.1111/liv.12791
    [17]
    石明霞, 张薇, 刘磊, 等. D-二聚体测定在慢性阻塞性肺疾病的疗效评价及预后意义的研究进展[J]. 现代生物医学进展, 2017, 17(29): 5797-5800. https://www.cnki.com.cn/Article/CJFDTOTAL-SWCX201729047.htm
    [18]
    黎尚荣, 沈宁, 易慧敏, 等. 肝肺综合征病人体肺循环及血浆iNOS、ET-1水平变化[J]. 南方医科大学学报, 2009, 29(10): 2030-2032. https://www.cnki.com.cn/Article/CJFDTOTAL-DYJD200910024.htm
    [19]
    王立国, 郭月宁, 刘喃喃, 等. 肿瘤坏死因子α在大鼠肝肺综合征发病机制研究[J]. 现代生物医学进展, 2021, 21(2): 219-222. https://www.cnki.com.cn/Article/CJFDTOTAL-SWCX202102006.htm
    [20]
    程凯, 杨振林, 吕长俊. ET-1、NO、NOS、ETB受体在大鼠肝肺综合征作用中的初步研究[J]. 滨州医学院学报, 2011, 34(6): 401-406. https://www.cnki.com.cn/Article/CJFDTOTAL-BZYB201106002.htm
  • Related Articles

    [1]XU Min, GAO Jing, ZHAO Huilan, WANG Meixia, JIAO Ruifen, LIU Xueqin, CHEN Xiao. Research on intake management in primipara labor analgesia during childbirth[J]. Journal of Clinical Medicine in Practice, 2024, 28(4): 79-83. DOI: 10.7619/jcmp.20233488
    [2]ZHANG Wen, LI Zhimao, YANG Chen, YAN Liyun, PENG Qi. Comprehensive nursing in induced labor primiparas treated by dinoprostone suppositories[J]. Journal of Clinical Medicine in Practice, 2020, 24(20): 127-129,132. DOI: 10.7619/jcmp.202020035
    [3]LIU Li, SUN Fei. Effect of Doula instrument combined with Doula accompanying on labor pain and quality of elderly primipara[J]. Journal of Clinical Medicine in Practice, 2020, 24(1): 112-115. DOI: 10.7619/jcmp.202001029
    [4]NIU Xiaoyan, ZHANG Xiaofang. Value of delivery ball and free position midwifery in delivery of primiparas[J]. Journal of Clinical Medicine in Practice, 2019, 23(24): 86-88. DOI: 10.7619/jcmp.201924027
    [5]ZHOU Qiaoning, WANG Huanxia. Value of delivery ball and free position of midwifery in promoting the delivery of primiparas[J]. Journal of Clinical Medicine in Practice, 2019, 23(17): 113-115. DOI: 10.7619/jcmp.201917032
    [6]YU Linling, LI Yun, HE Yan. Effects of continuous midwifery care services on the natural birth rate and choices of non-pharmacological analgesic delivery for primiparae[J]. Journal of Clinical Medicine in Practice, 2017, (14): 113-115. DOI: 10.7619/jcmp.201714034
    [7]LONG Yajing, ZHANG Weiping, FU Yun. The effect of risk assessment nursing on birth outcome and satisfaction of primiparae[J]. Journal of Clinical Medicine in Practice, 2016, (2): 105-107,111. DOI: 10.7619/jcmp.201602033
    [8]JIN Chunyan. The influence of grading nursing on postpartum complications of primipara and nursing satisfaction[J]. Journal of Clinical Medicine in Practice, 2014, (20): 96-98. DOI: 10.7619/jcmp.201420030
    [9]REN Xiuqiong. Perinatal mental state of primiparas and its influencing factors[J]. Journal of Clinical Medicine in Practice, 2014, (10): 122-123,126. DOI: 10.7619/jcmp.201410045
    [10]ZHOU Chunhua. Effect of nursing intervention on postpartum hemorrhage and sleep quality of primiparae with caesarean section[J]. Journal of Clinical Medicine in Practice, 2014, (8): 110-112. DOI: 10.7619/jcmp.201408041
  • Cited by

    Periodical cited type(5)

    1. 宋惠芳,王敏,李俊杰,冯宪梅. 共情共赢心理护理联合愉悦因子输入对有机磷农药中毒患者心理状况的影响. 医学理论与实践. 2024(10): 1760-1762 .
    2. 徐香港,汪杏. 重症有机磷农药中毒患者的急诊急救护理效果. 名医. 2024(01): 36-38 .
    3. 饶巧,张志坚,程春梅. 有机磷农药中毒康复期患者自我隐瞒现状及其影响因素. 中国工业医学杂志. 2024(03): 298-300 .
    4. 周创宇,兰浩云,张增强,李海峰. PSS、APACHE-Ⅱ评分对急性有机磷农药中毒患者近期预后不良预测价值比较. 现代医药卫生. 2024(22): 3849-3854 .
    5. 张丽平. 急性有机磷农药中毒康复期患者负性情绪现状调查及其影响因素分析. 心理月刊. 2024(23): 214-216 .

    Other cited types(2)

Catalog

    Article views (147) PDF downloads (8) Cited by(7)

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return