Correlação entre a contagem de plaquetas no sangue e o gradiente de pressão venosa hepática em pacientes cirróticos

Dittrich, S; Mattos, Ângelo Alves de; Cheinquer, Hugo; Araújo, Fernanda Schild Branco de

doi:10.1590/s0004-28032005000100009

Cited by 7 publications

(9 citation statements)

References 48 publications

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“…Various authors confirmed these findings, calling attention to the nonspecific character in relation to the cause of the event [21,22,23]. Other studies found an alteration in platelet adhesion function, which is evidenced earlier than aggregation defects, that in general are delayed, as demonstrated in the test of platelet function in patients with chronic hepatic insufficiency [24,25].…”

Section: Clinico-epidemiological Manifestationsmentioning

confidence: 90%

Characterization of HBeAg-negative chronic hepatitis B in western Brazilian Amazonia

Victoria¹,

Oliveira²,

Victoria³

et al. 2008

Braz J Infect Dis

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The present study was conducted with 55 patients native from western Brazilian Amazonia, who were HBV-DNA positive after seroconversion of HBeAg. It is a descriptive case study, with the patients separated into two groups: with hepatitis and without hepatitis on histological examination. The aim of the present study was to describe the clinical and molecular characteristics of patients who are chronic carriers of HBsAg. The prevalence of hepatitis was 63.64%, with a predominance of males (41.82%) and a mean age of 42.5 years, occurring mostly in natives of the southeast sub-region (32.73%). Time was a variable proportional to the course of the disease and the most frequent symptoms were: dyspepsia, asthenia and loss of libido with the majority of the patients having history of prior contact with HBV or positive family history. Splenomegalia was the most frequent sign (40%). Among the tests, platelet count, serum albumin and prothrombin activity were significant in the diagnosis of hepatitis. Alphafetoprotein was greater in patients with hepatitis, and hepatocellular carcinoma was detected in 3.63% of the patients with hepatic cirrhosis. Three types of HBV genotypes were diagnosed: A, D and F in the samples amplified for gene S. Genotype A (AA) was observed in 54.54% of the cases with hepatitis, in contrast to other studies showing the predominance of genotype F in this region. We observed mutations in 36.36%, with a predominance of the mutations in the core promoter region (31.81%), due to the greater prevalence of genotype A in this study. Key-Words: HBeAg-negative chronic hepatitis B, western Brazilian Amazonia, mutations.Western Brazilian Amazonia is considered a region of high endemicity for hepatitis B virus (HBV), where a large part of the population is infected in perinatal period and during infancy. The prevalence of chronic carriers of HBV surface antigen (HBsAg) in these areas varies between 5% and 15% and approximately 50% to 95% of the population show serologic evidence of past infection with HBV [1,2,3]. Various factors are implicated in the development and outcome of HBV infection, but the progression to chronic hepatitis is proportionally greater in individuals infected by the vertical route or during the perinatal period [4]. Chronic hepatopathies related to HBV are seen in two forms: HBeAg positive and HBeAg negative. The HBeAg-negative chronic forms are represented by two groups of patients: chronic inactive HBsAg carriers and chronic hepatitis B (CHB) patients. The distinction between these two forms is difficult, particularly in patients with biochemical and intermittent virologic activity. It is estimated that in the world there are approximately 350 million inactive HBsAg carriers, and of these, 7% to 30% are infected with mutant forms of HBV, which despite the presence of anti-HBe antibody continue to be HBV-DNA positive [5]. Chronic HBsAg carriers who show HBeAg-negative/antiHBe-positive serologic status and have serum HBV-DNA detectable by PCR and active hepatic disease characterized by ...

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Section: Clinico-epidemiological Manifestationsmentioning

confidence: 90%

Characterization of HBeAg-negative chronic hepatitis B in western Brazilian Amazonia

Victoria¹,

Oliveira²,

Victoria³

et al. 2008

Braz J Infect Dis

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“…The diagnosis of portal hypertension can be made by noninvasive methods, which include semiological data and complementary methods, and also by invasive methods including a direct approach of surgical measurement of the pressure in the portal system, or indirect methods that measure the wedged and free hepatic venous pressures, obtaining a hepatic venous pressure gradient between these two pressures (9) . The direct measurement of portal pressure is the most accurate for evaluating its actual increase (9) .…”

Section: Introductionmentioning

confidence: 99%

Avaliação do volume de fluxo portal em pacientes esquistossomóticos: estudo comparativo entre ressonância magnética e ultrassom Doppler

et al. 2010

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OBJETIVO: Avaliar a concordância entre o ultrassom Doppler e a ressonância magnética e a reprodutibilidade interobservador desses métodos na quantificação do volume de fluxo portal em indivíduos esquistossomóticos. MATERIAIS E MÉTODOS: Foi realizado estudo transversal, observacional e autopareado, avaliando 21 pacientes portadores de esquistossomose hepatoesplênica submetidos a mensuração do fluxo portal por meio de ressonância magnética (utilizando-se a técnica phase-contrast) e ultrassom Doppler. RESULTADOS: Observou-se baixa concordância entre os métodos (coeficiente de correlação intraclasse: 34,5% [IC 95%]). A reprodutibilidade interobservador na avaliação pela ressonância magnética (coeficiente de correlação intraclasse: 99,2% [IC 95%] / coeficiente de correlação de Pearson: 99,2% / média do fluxo portal = 0,806) e pelo ultrassom Doppler (coeficiente de correlação intraclasse: 80,6% a 93,0% [IC 95%] / coeficiente de correlação de Pearson: 81,6% a 92,7% / média do fluxo portal = 0,954, 0,758 e 0,749) foi excelente. CONCLUSÃO: Há uma baixa concordância entre o ultrassom Doppler e a ressonância magnética na mensuração do volume de fluxo na veia porta. A ressonância magnética e o ultrassom Doppler são métodos reprodutíveis na quantificação do fluxo portal em pacientes portadores de hipertensão porta de origem esquistossomótica, apresentando boa concordância interobservador

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“…In healthy patients, the porto-hepatic circulation compensates great variations in the blood flow with small variations in the portal pressure (1) . Pathological alterations in the hemodynamics of this system are characterized by a chronic increase in the portal venous pressure defined as portal hypertension secondary to an interference with the splanchnic venous blood flow and clinically translated into collateral circulation visible on the abdominal wall, ascites and esophagogastric alterations, i.e., esoph-gical measurement of the portal venous pressure or by indirect approach with the measurement of the occluded and free hepatic venous pressure aiming at obtaining the hepatic venous pressure gradient (3) corresponding to the difference between both pressures, that in healthy individuals should be < 5 mmHg (4) . The direct measurement of the portal venous pressure is the most effective method for evaluating its actual elevation.…”

Section: Introductionmentioning

confidence: 99%

“…The direct measurement of the portal venous pressure is the most effective method for evaluating its actual elevation. The measurement of the portal venous pressure levels can aid in the differential diagnosis of the causes for portal hypertension, in the evaluation of the risk for bleeding due to gastroesophageal varices rupture that is the main cause for morbimortality in these patients, in the evaluation of the medicamentous therapy effectiveness, in the prophylaxis of gastroesophageal varices bleeding, in the therapeutic decision making in cases of liver resection, and in the evaluation o the patients' prognosis (3,5) .…”

Section: Introductionmentioning

confidence: 99%

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Mensuração do volume de fluxo portal em pacientes esquistossomóticos: avaliação da reprodutibilidade do ultra-som Doppler

et al. 2008

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OBJETIVO: Avaliar a reprodutibilidade do ultra-som Doppler na quantificação do volume de fluxo portal em pacientes esquistossomóticos. MATERIAIS E MÉTODOS: Estudo prospectivo, transversal, observacional e autopareado, avaliando 21 pacientes portadores de esquistossomose hepatoesplênica, submetidos a mensuração do fluxo portal pelo ultra-som Doppler por três observadores, de forma independente, sendo calculada a concordância entre estes, dois a dois, pelo coeficiente de correlação intraclasse, teste t-pareado e grau de linearidade de Pearson. RESULTADOS: A concordância interobservador foi excelente. O coeficiente de correlação intraclasse variou entre 80,6% e 93,0% (IC a 95% [65,3% ; 95,8%]), com coeficiente de correlação de Pearson variando entre 81,6% e 92,7% e sem diferença estatisticamente significante entre os observadores quanto à média do fluxo portal mensurado pelo ultra-som Doppler (p = 0,954 / 0,758 / 0,749). CONCLUSÃO: O ultra-som Doppler é um método confiável para quantificar o fluxo portal em pacientes portadores de hipertensão porta de origem esquistossomótica, apresentando boa concordância interobservador.

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Correlação entre a contagem de plaquetas no sangue e o gradiente de pressão venosa hepática em pacientes cirróticos

Cited by 7 publications

References 48 publications

Characterization of HBeAg-negative chronic hepatitis B in western Brazilian Amazonia

Characterization of HBeAg-negative chronic hepatitis B in western Brazilian Amazonia

Avaliação do volume de fluxo portal em pacientes esquistossomóticos: estudo comparativo entre ressonância magnética e ultrassom Doppler

Mensuração do volume de fluxo portal em pacientes esquistossomóticos: avaliação da reprodutibilidade do ultra-som Doppler

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