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摘要：
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摘要：目的 比较球囊法和端孔导管法测量肝硬化患者肝静脉压力梯度（hepatic venous
pressure gradient，HVPG）的差异。方法 依次纳入2017年10月至2023年1月于首都医科大学
附属北京友谊医院同时通过球囊法与端孔导管法测量HVPG的肝硬化患者，分析术中造
影特点，比较2种方法测量的HVPG。根据是否合并肝内静脉分流（intrahepatic veno-venous
shunt，IHVS）分为无IHVS组（109例）和IHVS组（36例），比较同组患者球囊法与端孔
导管法测量HVPG的差异。采用Bland-Altman法分析两种测量方法的一致性。结果 145例肝
硬化患者球囊法和端孔导管法测得的HVPG差异无统计学意义 [（12.62 ± 4.73）mmHg 比
（12.80 ± 5.74）mmHg；t = 0.69，P = 0.492]。无IHVS组患者球囊法和端孔导管法测得的
HVPG差异无统计学意义 [（12.31 ± 4.77）mmHg比（11.83 ± 5.27）mmHg；t = －1.82，
P = 0.071]。IHVS组患者球囊法和端孔导管法测得的HVPG差异有统计学意义 [（13.53 ±
4.82）mmHg 比（15.75 ± 5.17）mmHg；t = 3.68，P = 0.001]。141（97.24%）例患者的测
量结果差值在正负1.96个标准差范围内，总体一致性良好。结论 球囊法与端孔导管法测
量的HVPG无显著差异，存在IHVS时建议应用端孔导管法。
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Abstract: Objective To observe the difference between the balloon and end-hole catheters
in measuring the hepatic venous pressure gradient (HVPG) in patients with liver cirrhosis.
Methods Patients who underwent HVPG measurement using both balloon and end-hole
catheter methods simultaneously in Beijing Friendship Hospital, Capital Medical University
from October 2017 to January 2023 were enrolled consecutively. The angiographic features
and the differences in HVPG measured by the two methods were analyzed. The patients were
divided into intrahepatic veno-venous shunt (IHVS) group and non-IHVS group according
to whether complicated with IHVS. The difference of HVPG measured by balloon and end
hole catheter in the same group was compared. The consistency of both measurements was
analyzed by Bland-Altman method. Results A total of 145 patients with liver cirrhosis were
enrolled. There was no significant difference between HVPG measured by balloon and endhole
catheter methods [(12.62 ± 4.73) mmHg vs. (12.80 ± 5.74) mmHg; t = 0.69, P = 0.492].
No statistically significant difference in HVPG was observed between the balloon and endhole
catheter methods in non-IHVS group [(12.31 ± 4.77) mmHg vs. (11.83 ± 5.27) mmHg; t =
－1.82, P = 0.071]. There was significant difference between HVPG measured by balloon and
end-hole catheter methods in IHVS group [(13.53 ± 4.82) mmHg vs. (15.75 ± 5.17) mmHg;
t = 3.68, P = 0.001]. The difference of HVPG in 141 (97.24%) patients were within ± 1.96
standard deviations, which showed good overall agreement. Conclusions Both the balloon
occlusion and end-hole catheter methods yield similar HVPG measurements, and the end-hole
catheter method was recommended for more accurate results in cases with IHVS.
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