Anahtar Kelimeler
portal Doppler ultrasonografi
hemodinamik değişiklikler
Öz
Alkol bağımlılığı bağımlılıklar arasında en sık görülenlerden biridir. Alkol bağımlıları ile yapılan karaciğer kan akımı çalışmaları farklı sonuçlar göstermektedir. Bazı yazarlara göre etanol alımını takiben karaciğer kan akımında artma olurken, bazıları bu sonucu desteklememektedirler. Alkol entoksikasyonunun hemodinamik etkileri ve portal hipertansiyonun etiyopatogenezi tam olarak anlaşılamamıştır.
Etanol alımı portal ve hepatik kan akımında artmaya neden olmaktadır. Ancak artmış portal ve hepatik kan akımı ile portal hipertansiyon arasında bir ilişki kurulamamaktadır. Bu ilişkinin yokluğu portal ve hepatik kan akımındaki artışın ya-nısıra hepatik dirençteki artış gibi diğer faktörlerin de portal basınçtaki artıştan sorumlu olabileceklerini düşündürmektedir.
Etanol ve metrabolitlerinin hepatik oksijen tüketimini arttırdığı ve böylece karaciğer kan akımında artmaya neden olduğu ileri sürülmektedir. Benzer şekilde kronik alkol tüketimi de karaciğer hastalığı olmayan kronik alkolik hastalardaki hepatik arter vazodilatasyonundan sorumlu olabilir.
Ancak Doppler ultrasonografi gibi non-invaziv ve güvenilir bir metod ile siroz, portal hipertansiyon ya da alkolik hepatit gibi alkol bağımlılığı olan hastalarda gelişmesi beklenen patolojiler gelişmeden önce, belirgin karaciğer hasarı bulguları da olmaksızın portal Dopplerin non-spesifik ancak hekimi uyarıcı öncü bulgular elde edilmesini sağladığı gözlenmiştir.
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