AIM:To evaluate portalsystemic hemodynamic changes in chronic severe hepatitis B.METHODS:Hemodynamic parameters included portal vein diameter (PVD),portal vein peak velocity (PVPV),portal vein volume (PW),spleen length (SPL),spleen vein diameter (SPVD),spleen vein volume (SPW) and umbilical vein recanalization.They were measured by Color Doppler ultrasonography in 36 patients with chronic severe hepatitis B,compared with 51 normal controls,61 patients with chronic hepatitis B,46 patients with compensable cirrhosis,and 36 patients with decompensable cirrhosis.RESULTS:In the group of chronic severe hepatitis B,PVD (12.38±1.23 mm) was significantly different from the normal control,compensable cirrhosis and decompensable cirrhosis groups (P = 0.000-0.026),but not significantly different from the chronic hepatitis group.PVPV (16.15±3.82 cm/s) dropped more significantly in the chronic severe hepatitis B group than the normal control,chronic hepatitis B and compensable cirrhosis groups (P = 0.000-0.011).PVV (667.53±192.83mL/min) dropped significantly as compared with the four comparison groups (P = 0.000-0.004).SPL (120.42±18.36 mm) and SPVD (7.52±1.52 mm) were longer in the normal control and chronic hepatitis B groups (P = 0.000-0.009),yet they were significantly shorter than those in the decompensable cirrhosis group (P = 0.000).SPVV (242.51±137.70 mL/min) was also lower than the decompensable cirrhosis group (P = 0.000).The umbilical vein recanalization rate (75%) was higher than the chronic hepatitis B and compensable cirrhosis groups.In the course of progression from chronic hepatitis to decompensable cirrhosis,PVD,SPL and SPVD gradually increased and showed significant differences between every two groups (P = 0.000-0.002).CONCLUSION:Patients with chronic severe hepatitis B have a tendency to develop acute portal hypertension,resulting in significantly reduced portal vein perfusion.Observation of the portalsystemic hemodynamic changes may be contributed to the disease progression of chronic liver disease.