彩色多普勒超声评价移植肝内血流动力学变化预测急性排异的初步研究  

Analysis of the hemodynamic changes of transplanted liver with acute rejection using color Doppler flow imaging：a preliminary study

作　　者：韩红[1] 王文平[1] 陈绍花 季正标[1] 丁红[1] 张晖[1] 闻捷先[1] 

机构地区：[1]复旦大学附属中山医院超声科,上海200032 [2]云南省曲靖市马龙县人民医院超声科

出　　处：《中华超声影像学杂志》2013年第6期496-499,共4页Chinese Journal of Ultrasonography

基　　金：上海市重点学科建设项目（B112）

摘　　要：【摘要】目的探讨通过彩色多普勒超声评价移植肝内血流动力学参数变化预测移植肝急性排异的可行性。方法68例移植肝患者，其中无明显排异活动者[排异活动指数（RAI）值〈3分]24例，轻度急性排异者（RAI值4～5分）23例，中重度急性排异者（RAI值6～9分）21例。所有患者均有穿刺病理学检查结果，穿刺前24h内及治疗1周后均进行彩色多普勒超声检查。结果移植肝中重度急性排异时，肝内门静脉峰值流速值（31．4±14．1）cm／s，明显低于移植肝无排异组（45．1±17．7）cm／s，差别有统计学意义（P〈（）．05）。治疗1周后随访，移植肝中重度排异组门静脉峰值流速上升，达（46．7±21．8）cm／s（P〈0．05）。结论移植肝内门静脉峰值流速下降对预测移植肝急性排异发生有一定价值。Objective To investigate the viability of analysis of hemodynamic changes with color Doppler flow imaging in the prediction of acute rejection in transplanted liver. Methods Sixty-eight patients enrolled in the study were categorized into three groups： transplanted liver without acute rejection [-rejection activityindex（RAI） 0-3, n ： 24],transplanted liver with mild acute rejection （RAI 4-5, n = 23）, transplanted liver with moderate and severe acute rejection （RAI 6 - 9, n = 21 ）. All the patients were confirmed by pathology. The color Doppler flow imaging were performed in all the patients within 24 hours and 1 week after biopsy. Results In transplanted liver with moderate and severe acute rejection,the peak systolic velocity of portal vein（PV-PSV） was （31.4± 14. 1 ）cm/s, significantly lower than that in transplanted liver without acute rejection, which was （45.1 ±17.7）cm/s （ P 〈 0.05）. A week later after steroid therapy, the PV-PSV in transplanted liver with moderate and severe rejection was increased to （46.7 ± 21.8）cm/s（ P 〈0.05）. Patients with acute rejection were associated with the decrease of the PV- PSV （ P 〈0.05）. Conclusions The decrease of PV-PSV may have some clinical value in evaluation the acute rejection in transplanted liver.

关 键 词：超声检查 多普勒 彩色 肝移植 移植物排异 门静脉 血流动力学现象 

分 类 号：R445.1[医药卫生—影像医学与核医学]