CAPABILITY OF FORECASTING THE COURSE OF LIVER CIRRHOSIS BY NON-INVASIVE LASER DOPPLER IMAGING

Abstract

Background. In patients with liver cirrhosis the ratio of serum endothelial factors, affecting peripheral microhemodynamics, depends on the degree of decompensation.
Objective. To determine the potential of non-invasive laser Doppler imaging in forecasting the course of liver cirrhosis of various stages of decompensation.
Materials and methods. A total of 65 patients with liver cirrhosis were examined, of these according to the Child-Pugh classification: class A – n=21, class B – n=28, class C – n=16. The study of peripheral microcirculation (perfusion (c.u), concentration (c.u), speed (mm\s)) was carried out using non-invasive laser Doppler imaging in the area of thenar and hypothenar. During the follow-up period in order to evaluate the prognosis of the clinical course of liver cirrhosis the ratio ΔP (difference in perfusion) was introduced while performing a cold test.
Results. The most informative in the evaluation of peripheral blood flow among patients with liver cirrhosis was the perfusion index. The correlation between the severity of microcirculatory changes and the stage of decompensation of liver cirrhosis was revealed. Perfusion difference ΔP> 25% evidenced a favorable course of the pathological process; ΔP <15% indicated an unfavorable clinical course; ΔP 15-25% was a doubtful result. Conclusion. In liver cirrhosis, significant disturbances at the peripheral microcirculatory level as well as the restructuring of the liver tissue are observed. The ratio of perfusion difference ΔP is considered as a criterion of preserving compensation of functional resources of microcirculatory blood flow in pathological condition.