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[Gaseous disorders and their role in the development of hepatopulmonary syndrome in liver cirrhosis associated with COPD].

OBJECTIVE
To evaluate the indicators of arterial blood gasometry and levels of nitric oxide (NO) in exhaled breath of patients with liver cirrhosis (LC) in combination with COPD, and determine frequency of occurrence of hepatopulmonary syndrome (HPS). The comparison group consisted of 20 patients with COPD, control - 15 volunteers. Gas measurement was estimated by ABL 725 radiometer (Denmark).


MATERIAL AND METHODS
We examined 57 patients with liver cirrhosis. The patients were divided into 2 groups: 1st--Patients with liver cirrhosis (n = 48), 2nd group--the CPU and COPD (n = 9). Comparison group consisted of 20 patients with COPD, control - 15 volunteers. The gasometry was evaluated by ABL 725 radiometer (Denmark). NO levels in exhaled air was estimated using the NIOX MINO (Sweden). Contrast electrocardiography was performed on ATL HDI 5000 (Bothell, WA, USA).


RESULTS
We found that the PaO2 was lower in the 2nd group compared with the control and with the 1st group (81.4 +/- 5.2; 95.5 +/- 5.3 and 94.5 +/- 5.1 mm Hg; p < 0.05), but the lowest PaO2 was in the group with COPD (68.4 mm Hg). AaDO2 was higher in the group with COPD (37.7 mm Hg). In the 2nd group this indicator was higher as compared with the control and with the 1st group (26.8 +/- 5.4; 8.2 +/- 4.5 and 14.9 +/- 5.2 mm Hg; p < 0.05). A strong negative correlation in the 1st and the 2nd groups between AaDO2 and PaO2 (r = -0.67 and r = -0.93; p < 0.05) was obtained. Content of NO in exhaled air was higher in the 1st and 2nd groups compared with control (18.7 +/- 4.1; 18,9 +/- 4.5 and 11.0 +/- 3.3 ppb; p < 0.05). Intrapulmonary shunts were detected in 3 patients in the 1st and 2nd groups.


CONCLUSION
The relationship between measures of blood gas composition showed the leading role of hypoxemia in increasing the risk of formation of HPS in the LC, especially when combined with COPD.