간경변증 환자 29예에서 혈장량, 심박출량 및 신혈장류량을 동시에 측정하여 혈역학적 변화를 관찰하였으며 다음과 같은 결론을 얻었다. 1) 평균 혈장량은 3793±895ml로 정상보다 증가된 것을 보았고 혈액량 (5266±1222ml) 및 체중 kg당 혈액량 (95.7±23.41ml)도 역시 증가되어 있었다. 체중 kg당 혈장량 (69.1±19.1ml)은 증가하는 경향을 보였고 혈액량과 혈장량의 차, 즉 적혈구질량은 26.4±7.05ml로 정상범위내에 있었다. 2) 평균 심박출량은 7708±2652ml/min로 증가되어 있었으며 심계수(4924±1998ml/min/M2) 심박동량 (96.2±34.2ml/beat), 심박동계수 (62.3±27.34ml/M2) 및 분별심계수 (1.54±0.577)도 모두 증가함을 보았다. 전말초저항은 1664±753.8 dynes sec cm-5M2로 정상보다 감소되어 있었다. 3) 평균 신혈장류량은 537±146.8ml/min/1.73M2로 정상 내지는 감소된 것을 보였고, 평균 creatine clearance는 66.7±23.0ml/min/1.73M2로 현저한 저하를 보았다. filtration fraction은 일정치 않았으나 대부분의 예에서 감소되었다. 심박출량의 신분별치는 상대적으로 감소하여 있었다. 4) 신혈장류량은 전반적으로는 정상 또는 저하되어 있었으나 creatine clearance가 60ml/min/1.73M2 이하인 군과 치료에 저항하는 복수군 및 공소혈증이 있는 예에서 현저한 감소를 보였다. 5) 본실험에서 관찰한 사구체 여과율의 감소, filtration fraction의 저하 및 심박출량의 신분별치의 감소등은 신장의 수입세동맥저항의 상승을 뒷받침한다. 6) 간경변증에서 신순환 장애는 공소혈증이나 핍뇨에 선행하여 일어남을 알 수 있었다. 7) 임상상이나 간기능 성적은 이들 혈역학 변화와 상관관계가 없었고 다만 식도 정맥류가 심박출량이 증가된 예에서 관찰되었다. 8) 신혈역학 변화와 혈장량 혹은 심박출량 간에도 상관관계는 없었다.

Cardiac output, plasma volume and renal plasma flow were determined to evaluate hemodynamic changes in 29 patients with cirrhosis of the liver. The results obtained were as follows. 1) The mean plasma volume was 3793±895ml and it was significantly higher than the normal controls. The mean blood volume (5266±1222ml) and blood volume per kg body weight (95.7±23.41ml) were also increased significantly. The mean plasma volume per kg body weight (69.1±19.1ml) showed increased tendency and the mean difference between blood volume and plasma volume per kg body weight (26.4±7.05ml) was in lower limit of normal range. 2) The mean cardiac output was 7708±2652ml/min and it was significantly increased. The mean cardiac index (4924±1998ml/min/M2), stroke volume (96.2±34.2ml/beat), stroke index (62.3±27.34ml/beat/M2) and fractional cardiac index (1.54±0.577) were also increased significantly. The mean total peripheral resistance was 1664±753.8 dynes sec cm-5 M2 and it was significantly lower than the normal controls. 3) The mean renal plasma flow was 537±146.8ml/min/1.73M2 and it was normal to decreased tendency. The mean endogenous creatinine clearance (66.7±23.0ml/min/1.73M2) was significantly decreased. Filtration fraction was variable, but it was slightly lower than normal in most cases. The mean renal fraction of cardiac output (11.4±6.27%) was relatively decreased. 4) Although renal plasma flow was normal or decreased in general, it was definitely diminished in patients with creatinine clearance less than 60ml/min/1.73M2, resistant ascites, and signs of azotemia (elevated BUN and serum creatinine). 5) Diminished glomrular filtration rate with low filtration fraction and decreased renal fraction of cardiac output observed strongly supported increased renal afferent arteriolar resistance. 6) Renal circulatory impairment preceded azotemia or oroliguria in cirrhosis. 7) Clinical findings and liver function were not correlated with hemodynamic changes, except for esophageal varices associated with high cardiac output observed. 8) No definite correlation of renal hemodynamics with plasma volume or cardiac output was found.