慢性病毒性肝炎胆囊超声观察指标与肝脏组织病理G、S关系研究  

Correlation between Gallbladder Indexes Observed with Ultrasound and Liver Pathological G/S in Patients with Chronic Viral Hepatitis

作　　者：孟繁坤[1] 杨琛 刘英[3] 张海英[4] 丁蕾[4] 郑颖[4] 穆晓洁[4] 

机构地区：[1]苒都医科大学附属北京佑安医院超声科,北京市100069 [2]河北省定兴县医院超声科 [3]唐山市第二医院超声科 [4]首都医科大学附属北京佑安医院超声科,北京市100069

出　　处：《中国超声医学杂志》2010年第8期738-741,共4页Chinese Journal of Ultrasound in Medicine

基　　金：北京市科技计划重大项目(No.H020920020490)

摘　　要：目的探讨慢性病毒性肝炎不同炎症分级(G)、肝组织病理纤维化(S)分期与胆囊壁超声改变关系及其临床意义。方法对照组102例为体检健康者。病例组402例按肝穿结果纤维化分为S0～S4五期、炎症分为G1～G4四级。在肝穿后7d内应用超声观察胆囊的大小、胆囊壁的声像图表现,将观察的结果与G与S及临床化验进行对照分析。结果胆囊壁的异常表现包括毛糙、增厚毛糙、双边影征;病例组与对照组之间胆囊各观察指标比较:胆囊壁异常表现、胆囊大小差异有显著性。S分期中,胆囊长径S0-3与S4之间差异有显著性;胆囊壁厚度、胆囊壁毛糙S0-2与S3-4之间差异有显著性。G分级中,胆囊长径G1与G2、G2与G3-4之间差异有显著性;胆囊壁厚度G1-2与G3-4之间差异有显著性;胆囊壁毛糙G1-3与G4之间差异有显著性。结论慢性病毒性肝炎患者胆囊大小、胆囊壁声像图异常改变随着G、S分期增加而增加,综合考虑各项指标的变化有助于临床评估慢性病毒性肝炎的病情发展。Objective To investigate correlation between defferent grades and stages （G/S） of chronic viral hepatitis and ultrasound changes of gallbladder wall and their clincial significance. Methods 102 cases in the control group were health subjects in the physical test. 402 patients were divided into 5 stages ranging from SO （no liver fibrosis） to S4 （liver cirrhosis） according to the staging of liver fibrosis, and 4 grades ranging from G1 to G4 according to the grading of inflammation identified with the results of needle biopsy of the livers. The size of the gallbladders and image manifestation of the gallbladder walls were observed with ultrasonography within 7 days before and after needle biopsy of the livers, and the results of needle biopsy of livers were compared and analyzed with the liver fibrosis staging （S）, inflammation grading （G） and the results in the clincial tests. Results The abnormalities of gallbladder wall included rough, thickened rough, and double layer echo. The differences of gallbladder wall abnormality and gallbladder size was of significance by comparing the various indexes of gallbladders observed in the patient group and the control group. In the staging, the difference of gallbladder length between SO-S3 and S4 was of significance and the differences of thickness and roughness of the gallbladder walls between SO-2 and S3-4 were of significance. In the grading, the difference of gallbladder length between G1 and G2 and between G2 and G3-4 was of significance the difference of thickness of the gallbladder walls between G1 2 and G3 4 was significant. The difference of roughness of the gallbladder walls between G1-3 and G4 was significant. Conclusions The gallbladder size and the abnormal change of gallbladder wall in patients with chronic viral hepatitis increase with G upgrading and S upstaging. So, it is helpful in the clinical evaluation of the disease progression of chronic hepatitis by comprehensively considering the changes of va rious gallbladder indexes of the pati

关 键 词：慢性病毒性肝炎 超声诊断 胆囊炎 

分 类 号：R512.6[医药卫生—内科学]