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논문 기본 정보

자료유형
학술저널
저자정보
Kotani Kohei (Department of Hepatology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan) Kawada Norifumi (Department of Hepatology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan)
저널정보
거트앤리버 발행위원회 Gut and Liver Gut and Liver Vol.18 No.1
발행연도
2024.1
수록면
27 - 39 (13page)
DOI
10.5009/gnl230072

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In chronic liver disease, hepatic stellate cell activation and degeneration of liver sinusoidal endothelial cells lead to structural changes, which are secondary to fibrosis and the presence of regenerative nodules in the sinusoids, and to functional changes, which are related to vasoconstriction. The combination of such changes increases intrahepatic vascular resistance and causes portal hypertension. The subsequent increase in splanchnic and systemic hyperdynamic circulation further increases the portal blood flow, thereby exacerbating portal hypertension. In clinical practice, the hepatic venous pressure gradient is the gold-standard measure of portal hypertension; a value of ≥10 mm Hg is defined as clinically significant portal hypertension, which is severe and is associated with the risk of liver-related events. Hepatic venous pressure gradient measurement is somewhat invasive, so evidence on the utility of risk stratification by elastography and serum biomarkers is needed. The various stages of cirrhosis are associated with different outcomes. In viral hepatitis-related cirrhosis, viral suppression or elimination by nucleos(t)ide analog or direct-acting antivirals results in recompensation of liver function and portal pressure. However, careful follow-up should be continued, because some cases have residual clinically significant portal hypertension even after achieving sustained virologic response. In this study, we reviewed the current and future prospects for portal hypertension.

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