الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
Pulmonary abnormalities and symptoms are common in patients
with chronic liver disease and up to 70% of cirrhotic patients undergoing
evaluation for liver transplantation complain of dyspnea. Pulmonary
dysfunction has been seen in approximately one third of patients with
chronic liver disease .
A variety of causes for pulmonary dysfunction in liver disease have
been identified and include intrinsic cardiopulmonary disorders not
specifically related to liver disease as well as unique problems associated
with the presence of liver disease and/or portal hypertension.
Our study aimed to study the pattern and the extent of pulmonary
function affection in cirrhotic patients and its relation to the Child- Pugh
classification and to Model For End Stage Liver Disease Score (MELD
score).
This study was carried out on 90 subjects divided into three groups
according to Child –Pugh score: 30 patients Child-Pugh A group, 30
patients Child-Pugh B group and 30 patients Child-Pugh C group. All
patient included in this work have documented liver cirrhosis, their chest
were radiologically free.
All patients were subjected to complete history taking and physical
examination, abdominal ultrasonography, chest x ray, pulmonary function
tests.
We found that 55.56% of the patients being studied complaining of
dyspnea. The result obtained from the flow volume data revealed a
decrease in all values of patient’s group in comparison to predicted value;
this indicates the presence of a mild mixed obstructive and restrictive
ventilatory pattern especially in advanced degree of Child-Pugh score.
The pulmonary changes seen in cirrhotic patients were closely related to
the degree of hepatic involvement as when comparing the pulmonary
function test parameters, the FEV1 and FVC values were found to be
lower in the Child–Pugh C group.
This study shows that pulmonary functions impairment in patients
with liver cirrhosis is accentuated with presence of ascites; we found that
of pulmonary function tests parameters FEV1 and FVC were significantly
lower than the predicted value in patients with ascites compared to those
without.
This study found a significant inverse relationship between FVC
(as percent of predicted) and serum bilirubin concentration and a highly
significant positive correlation between FVC and S. albumin in the
studied patients.
In conclusion this work might point to the pulmonary function
abnormalities in patients with liver cirrhosis leading to a significant
obstructive ventilatory defect at the level of both small and large airways.
Ascites cause significant reduction in the FVC, FEV1.