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.
DownLoad: