多普勒超声测定乙型肝炎肝硬化患者肾动脉血流参数与Fibroscan测值的相关性分析  

Relationship between hemodynamic changes of renal artery measured by color Doppler ultrasound and fibroscan value in patients with hepatitis B cirrhosis

作　　者：程小飞 梁雄波 熊晓青 唐永丽 陈萍 

机构地区：[1]中山市第二人民医院影像科,广东中山528447

出　　处：《中国肝脏病杂志（电子版）》2016年第2期107-109,共3页Chinese Journal of Liver Diseases：Electronic Version

基　　金：广东省中山市科技局社会发展公关计划项目(20132A050)

摘　　要：目的探讨应用彩色多普勒超声显像仪以及瞬时弹性成像(Fibroscan)观察和分析乙型肝炎肝硬化患者的肾动脉血流动力学改变的意义。方法选择2011年1月至2015年3月收治的乙型肝炎肝硬化患者182例,另选健康对照150例,使用彩色超声多普勒显像仪检测肾动脉舒张期最低血流速度(renal artery diastolic minimum blood flow velocity,RAVdmin)、肾动脉阻力指数(renal artery resistance index,RARI)和肾动脉搏动指数(renal artery pulsatility index,RAPI);同时进行Fibroscan检测,结果以肝硬度(LSM)表示。结果肝硬化患者RARI、RAPI和LSM值分别为0.85±0.11、1.94±0.53和(25.8±7.65)k Pa,显著高于正常对照组的0.56±0.28、0.83±0.08、(7.5±3.1)k Pa(t值分别为11.9477、27.8716、29.4694,P值为0.041、0.039、0.033);肝硬化患者的RAVdmin为(8.63±1.89)cm/s,显著低于正常对照组的(16.53±2.86)cm/s,(t=29.0101,P=0.033)。肝硬化患者LSM值与RARI和RAPI呈正相关(r值分别为0.64、0.56,P值分别为0.00021、0.00043)。结论利用Fibroscan测量肝脏硬度以及彩色多普勒超声动态检测乙型肝炎肝硬化患者肾动脉血流动力学变化,对乙型肝炎肝硬化患者肝肾功能的监测具有重要意义。Objective To explore the relationship between hemodynamic changes of renal artery measured by color Doppler ultrasound and fibroscan value in patients with hepatitis B cirrhosis. Methods Total of 182 patients with hepatitis B cirrhosis who were admitted to the Second People＇s Hospital of Zhongshan from January 2011 to March 2015 as well as 150 healthy controls were recruited. The mean renal artery diastolic minimum blood flow velocity（RAVdmin）, renal artery resistance index（RARI） and renal artery pulsatility index（RAPI） were measured by color Doppler ultrasound. Fibroscan was also carried out. Results The RARI, RAPI, and Fibroscan values of patients with hepatitis B cirrhosis were 0.85 ± 0.11, 1.94 ± 0.53 and（25.8 ± 7.65） k Pa, respectively, and they were significantly higher than those of the control group [0.56 ± 0.28, 0.83 ± 0.08 and（7.5 ± 3.1） k Pa]（t = 11.9477, 27.8716, 29.4694; P = 0.041, 0.039, 0.033）. The RAVdmin of patients with hepatitis B cirrhosis [（8.63 ± 1.89） cm/s] were significantly lower than that of the control group [（16.53 ± 2.86） cm/s]（t = 29.0101, P = 0.033）. The Fibroscan value was positively correlated with RARI and RAPI（r = 0.64, 0.56; P = 0.00021, 0.00043）. Conclusion The liver stiffness assessed by Fibroscan and the hemodynamic changes of the renal artery measured by color Doppler ultrasound are vitally important for evaluating the severity of patients with hepatitis B cirrhosis.

关 键 词：肝炎 乙型 肝硬化 肾动脉 血流动力学 超声检查 多普勒 彩色 弹性成像技术 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学] R445.1