超声测定DSMV和PVD及其增宽率对血吸虫肝硬化的预测效能及与肝硬化程度关系  

Predictive efficacy of ultrasound measurement of DSMV,PVD and its widening rate for schistosomiasis cirrhosis and its relationship with the degree of liver cirrhosis

作　　者：季春艳 刘明春[1] 王瑜[1] 祝凤翠 JI Chun⁃yan;LIU Ming⁃chun;WANG Yu;ZHU Feng⁃cui(Department of Ultrasound,Panzhihua Integrated Traditional Chinese and Western Medicine Hospital,Panzhihua,Sichuan 617000,China)

机构地区：[1]攀枝花市中西医结合医院超声科,四川攀枝花617000

出　　处：《热带医学杂志》2022年第7期987-991,共5页Journal of Tropical Medicine

基　　金：四川省科技计划项目(2018JDR3299)

摘　　要：目的探究超声测定肠系膜上静脉内径(DSMV)、门静脉主干内径(PVD)及其增宽率预测血吸虫肝硬化的效能及与肝硬化程度的相关性。方法选取2018年5月-2020年10月攀枝花市中西医结合医院70例血吸虫肝硬化患者作为研究组,另选取同期70名健康体检者为对照组。比较两组临床资料、门静脉流速、DSMV、PVD增宽率。比较研究组不同肝硬化程度患者DSMV、PVD及其增宽率,分析DSMV、PVD与门静脉流速、肝硬化程度的相关性。研究组随访6个月,统计不同肝硬化程度患者急性肾损伤(AKI)发生率,比较发生与未发生AKI患者入院时DSMV、PVD,分析DSMV、PVD预测血吸虫肝硬化并发AKI的价值。结果研究组有疫区生活史者构成比(72.86%)、DSMV(9.20±1.68)mm、PVD(12.40±1.71)mm,及DSMV、PVD增宽率(92.86%、41.43%)均大于对照组(P<0.05),门静脉流速(11.85±3.74)cm/s低于对照组(P<0.05)。研究组DSMV、PVD与门静脉流速成负相关(r=-0.626、-0.666,P均<0.05)。研究组肝硬化程度DSMV、PVD均为C级>B级>A级(P均<0.05)。研究组DSMV、PVD与肝硬化程度成正相关(r=8.823、6.994,P均<0.05)。研究组肝硬化程度A级患者AKI发生率为9.09%,低于B级(32.26%)、C级(52.94%),差异有统计学意义(P<0.05)。研究组发生AKI患者DSMV、PVD均大于未发生AKI患者(P<0.05)。DSMV、PVD预测血吸虫肝硬化并发AKI的曲线下面积分别为0.871、0.868,联合预测的曲线下面积最大,为0.917。结论血吸虫肝硬化患者DSMV、PVD及其增宽率明显增加,且DSMV、PVD与患者门静脉流速、肝硬化程度密切相关,在预测血吸虫肝硬化患者AKI发生风险方面具有一定价值。Objective To explore the effectiveness of ultrasound measurement of superior mesenteric vein diameter(DSMV),portal vein diameter(PVD)and the widening rate in predicting schistosomiasis cirrhosis and the correlations with the degree of liver cirrhosis.Methods A total of 70 patients with schistosomiasis cirrhosis in Panzhihua integrated traditional Chinese and Western medicine hospital from May 2018 to October 2020 were selected as the research group,and70 healthy patients during the same period were selected as the control group.The clinical data,portal vein flow rate,DSMV,and PVD widening of the two groups were compared.The DSMV,PVD and the widening rates of patients with different degrees of cirrhosis in the study group were compared;the correlations between DSMV,PVD and portal vein flow rate and the degree of liver cirrhosis in the study group were analyzed.The study group was followed up for 6 months and the acute kidney injury(AKI)incidence rate was determined.The DSMV and PVD at admission of patients with and without AKI were compared;the values of DSMV and PVD in predicting schistosomiasis cirrhosis with AKI were analyzed.Results The constituent ratio(72.86%),DSMV(9.20±1.68)mm,PVD(12.40±1.71)mm and their widening rates(92.86%,41.43%)in the study group were higher than those in the control group,and the portal vein velocity(11.85±3.74)cm/s was lower than that in the control group(P<0.05).DSMV and PVD were negatively correlated with portal vein velocity in the study group(r=-0.626,-0.666,all P<0.05).In the study group,DSMV and PVD in Grade C patients were higher than those in Grade B patients,and those in Grade B patients were higher than those in Grade A patients(P<0.05).DSMV and PVD were positively correlated with the degree of liver cirrhosis in the study group(r=8.823,6.994,all P<0.05).In the study group,the incidence of AKI in patients with grade A cirrhosis was 9.09%,which was significantly lower than grade B(32.26%)and grade C(52.94%)(P<0.05).DSMV and PVD in patients with AKI in the study group were

关 键 词：血吸虫肝硬化 超声 肠系膜上静脉内径 门静脉主干内径 增宽 肝硬化程度 

分 类 号：R575.2[医药卫生—消化系统] R532.21[医药卫生—内科学]