彩色多普勒超声监测原位肝移植术后急性排斥反应的应用研究  

Color Doppler Flow Image in Monitoring Acute Rejection after Orthotopic Liver Transplantation

作　　者：白敏[1] 杜联芳[1] 王书云[2] 

机构地区：[1]上海交通大学附属第一人民医院超声科,上海市200080 [2]上海交通大学附属第一人民医院肝移植科,上海市200080

出　　处：《中国超声医学杂志》2009年第8期788-790,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨彩色多普勒超声（CDFI）监测原位肝移植术后急性排斥反应（AR）的应用价值。 方法CDFI检测34例AR患者的血流动力学参数,并与89例术后无并发症患者对照分析。主要观察指标：肝动脉收缩期峰值流速（PS）、阻力指数（RI）,门静脉主干平均流速（Vm）,肝右静脉平均流速（Vm）及频谱波形。 结果移植肝AR组的各项血流参数指标与对照组相比：（1）术后2周内两组各指标差异无统计学意义（P〉0.05）;（2）术后2周后两组间门静脉Vm,肝动脉PS差异无统计学意义（P〉0.05）;AR组RI（0.75±0.07）,较对照组升高,差异有统计学意义（P〈0.01）;AR组有8例（8/10,80%）肝静脉频谱形态变钝,肝静脉Vm（18.40±3.44）cm/s较对照组减低,与对照组相比差异有统计学意义（P〈0.01）。 结论CDFI对诊断发生于术后2周后的AR有一定意义,并能追踪观察AR的转归。Objective To explore the value of color Doppler flow image （CDFI）in the diagnosis of acute rejection （AR） after orthotopic liver transplantation（OLT）.Methods 34 cases with AR underwent CDFI to observe the vascular hemodynamic changes,which were compared with 89 cases without complication after OLT.Monitoring parameters incuded hepatic artery maximum velocity（PS）,resistance index（RI）,portal vein mean velocity（Vm）,the hepatic vein mean velocity（Vm） and waveform.Results The AR group was compared with the control group：1）There was no significant difference in all the parameters between the two groups within postoperative 2 weeks（P〉0.05）, 2） after postoperative 2 weeks：there was no significant difference in PV-Vm and HA-PS （P〉0.05）.RI of the AR group was（0.75±0.07）higher than that of the control group （P〈0.01）. 8 of 10 cases with AR had damping of the pulsatile blood flow of the hepatic veins.Their HV-Vm was （18.40±3.44）cm/s and lower.There was significant difference in these parameters （P〈0.01）.Conclusions CDFI is useful for the diagnosis of AR that occurs after 2 weeks postoperation and the following-up period.

关 键 词：彩色多普勒超声 急性排斥反应 血流动力学 

分 类 号：R657.3[医药卫生—外科学] R699.2[医药卫生—临床医学]