肝硬化门脉高压症超声血流参数对门静脉压力的影响  

Correlation between homodynamic parameters measured by ultrasound on portal vein′s pressure in patients with hepatic cirrhosis and portal hypertension-Analyzed by stepwise regression

作　　者：雷震[1] 杨世梅[1] 罗燕[2] 

机构地区：[1]深圳市南山区人民医院,广东深圳518052 [2]四川大学华西医院,四川成都610041

出　　处：《海南医学院学报》2011年第6期833-836,841,共4页Journal of Hainan Medical University

基　　金：海南医学院科研基金资助学报项目(0020110214)~~

摘　　要：目的：研究肝硬化门脉高压症多个超声参数对门静脉压力的影响。方法：观察25例患者（门体压差大于或等于5 mmHg18例为试验组,小于5 mmHg 7例为对照组）的腔静脉、门静脉、脾静脉及肠系膜上静脉的超声血流参数,对照经颈内静脉肝内门体分流术（TIPS）导管测量的门静脉压力,利用多元逐步回归分析来研究门静脉内径（x1）、门静脉流速（x2）、门脉流量（x3）、脾静脉内径（x4）、脾静脉流速（x5）、肠系膜上静脉内径（x6）和肠系膜上静脉流速（x7）对门静脉压力（y）的影响。结果：试验组门静脉、脾静脉、肠系膜上静脉内径大于对照组（P〈0.05~0.01）,下腔静脉内径小于对照组（P〈0.05）,试验组门静脉流速小于对照组（P〈0.01）;试验组脾静脉和肠系膜上静脉流量均高于对照组（P〈0.05~0.01）;建立多元逐步回归方程为：y=36.976-2.609x1-11.990x2＋0.032x3,门静脉流速对门脉压力影响最大。结论：肝硬化门脉高压患者的门脉压力与超声测量门脉血流动力学参数密切相关,可能利用超声参数初步估计门脉压力。Objective： To analyze the correlation between homodynamic parameters measured by ultrasound on portal vein′s pressure in patients with hepatic cirrhosis and portal hypertension by stepwise regression.Methods： Twenty-five patients with hepatic cirrhosis（HC） were enrolled in this study,of which 18 cases with PVP 5 mmHg were assigned into experiment group,and 7 cases showing PVP5 mmHg were assigned into control group.Ultrasonic parameters of portal vein（PV）,splenic vein（SV）,Superior mesenteric vein（SMV）of the experiment group were collected.And portal vein′s pressures（PVP） of the control group were measured by catheter in operation of Transjugular intrahepatic portosystemic shunt（TIPS）.Relations between portal vein′s pressure（y） and parameters including PV′s diameter（x1）,the PV′s flow velocity（x2）,the PV′s blood volume（x3）,SV′s diameter（x4）,the SV′s flow velocity（x5）,the SMV′s blood volume（x3） were analyzed by stepwise regression.Results： The PVP（y） significantly correlated with the following parameters.The experiment group showed significant larger diameters of SV,PV and SMV（P0.05~0.01）,but maller postcava diameter（P0.05） comparing with the control group.The experiment group showed slower PV′s velocity（P0.05） but quicker velocity of SV and SMV（P0.01）.The correlation equation was ＂y =36.976-2.609x1-11.990x2＋0.032 x3＂ indicating that PV′s flow velocity had the greatest influence on portal vein′s pressure.Conclusions： Ultrasonic parameters are closely related to PVP.The established equation of analysis of stepwise regression（AOSR）can be used to predicate PVP.

关 键 词：肝硬化 门静脉高压症 经颈静脉门体静脉分流术 超声显像 血流动力学 

分 类 号：R657.34[医药卫生—外科学]