ウイルス性肝炎及び肝硬変の肝循環動態に関する研究 第一編 慢性肝炎の肝循環動態に関する研究

By means of catheterization of hepatic veins, hepatic hemodynamics was investigated on patients with chronic hepatitis. 1. Elevation of wedged hepatic venous pressure and reduction of effective hepatic blood flow were noted. In 30% of the cases intrahepatic shunt flow was positive. Oxygen consumption of the visceral organ was reduced in 20% of the cases. 2. There was a close relationship among the factors of hepatic hemodynamics, such as wedged hepatic venous pressure, effective hepatic blood flow, intrahepatic shunt flow, etc. Moreover, the amount of oxygen consumtion of the visceral organ was related to effective hepatic blood flow. 3. Correlation was observed between wedged hepatic pressure and the active histological alterations of Glisson's capsule. Effective hepatic blood flow was closely related to the laboratory findings of the liver function and the changes of portal vein in the Glisson's capsule. Intrahepatic shunt flow was related to laboratory findings of the liver function, histological changes of Glisson's capsule, degeneration of the liver cells, alterations of central veins and splenomegaly. The amount of oxygen consumption of the visceral organ was related to blunted liver edge, splenomegaly and enlargement of the sinusoids. 4. In chronic hepatitis manifested with latent form, a remarkable disturbance of heparic hemodynamics was observed. This type of hepatitis may thus have a possibility to progress to cirrhosis. Similar observations were obtained in the clinical type of relapsing hepatitis and in that with obscure clinical manifestations.