超声检查在戊型肝炎诊断中的应用价值  

The value of the ultrasonography on the diagnostics of viral hepatitis type E

作　　者：崔新莉 杨嵘[2] 

机构地区：[1]洛浦县人民医院超声科,新疆和田848200 [2]新疆维吾尔自治区人民医院超声科,乌鲁木齐830001

出　　处：《新疆医学》2015年第10期1422-1423,1421,共3页Xinjiang Medical Journal

摘　　要：目的观察戊型肝炎患者多年后有无慢性化进展趋势。方法回顾2011年1月~2014年7月期间来我院就诊的暴发流行的戊型肝炎病人症状,实验室及超声检查。结果回顾患者178例,HEVIg M阳性2例（1.12%）、HEV Ig G阳性69例（38.76%）、HBs Ag阳性13例（7.30%）;血清丙氨转氨轻度生高23例（12.92%）、A/G比例改变41例（23.03%）;经超声检查肝脏及临近器官回声异常的73例,主要超声异常声像如下：肝脏增大,边缘较钝,肝被膜增厚,回声增强、增粗,均匀性紊乱41例（30.33%）;肝回声弥漫性增强14例（7.87%）;肝实质回声不均匀,肝内光点增粗增强,分布紊乱,有弥漫性不规则低回声18例（10.11%）。胆囊壁不同程度的增厚,回声增强19例（10.67%）,合并结石11例（6.18%）,胆囊壁血流信号无特殊改变。门静脉增宽5例（2.81%）。脾脏增大,部分伴有脾静脉扩张13例（7.30%）。结论戊型肝炎超声图像改变与肝功能有很好的对应性,与细胞免疫有相关性,可出现肝内胆汁淤积甚至,发展为慢性肝炎,提示超声检查在戊型病毒性肝炎的诊断和鉴别诊断上有重要意义。Objective To observe whether subjects undergoing hepatitis E could transform into chronic hepatitis years later.Methods Symptoms,laboratory tests and ultrasound results of the Patients who had hepatitis E when hepatitis E outbreak in our hospital from January 2011 to July 2014 were reviewed.Results Among 178 cases,there were 2 cases with positive HEV Ig M（1.12%）,69 cases with HEV Ig G being positive（38.76%）,13 cases with HBs Ag being positive（7.30%）; Furthermore,there were 23 cases with increasing serum ammonia（12.92%） and 41 cases with A/G ratio change（23.03%）; By ultrasound,73 cases were found abnormal liver and adjacent organs ultrasound.Main abnormal ultrasonic acoustic image is as follows：increasing liver,dull edge,thickening liver capsule,echogenicity,enlargement,uniformity of disorder,which amounted to 41 cases（30.33%）; There were 14 cases who got Liver echo diffuse enhancement（7.87%）; There were 18 cases having uneven liver parenchyma echo,intrahepatic dot enlargement,disorder distribution and diffuse irregular low echo（10.11%）.There were 19 cases having the different thickening gallbladder wall and stronger echo（10.67%）,11 cases（6.18%） having calculi and no special changes about blood flow signals of gallbladder wall.There were 5 cases having widen portal vein（2.81%）.There were 13 cases having spleen enlargement,and some of which were accompanied by spleen vein expansion（7.30%）.Conclusion Sonographic changes of Hepatitis E can reflect liver function and cellular immune system.Along with sonographic changes of liver,there may be intrahepatic cholestasis,and even develop chronic hepatitis,which suggests that ultrasound is important to diagnosis and differential diagnosis for viral hepatitis.

关 键 词：戊型肝炎 随访 超声检查 

分 类 号：R512.6[医药卫生—内科学]