肝脏渡越时间在门静脉高压-食管胃底静脉曲张患者门静脉压力评估中的应用  

Application of hepatic transit time in portal vein pressure assessment in patients with portal hypertension and esophago gastric varices

作　　者：林元强[1] 姜博[2] 李鹤群[1] 金春香[1] 王辉[1] LIN Yuanqiang;JIANG Bo;LI Hequn;JIN Chunxiang;WANG Hui(Department of Ultrasound,China-Japan Union Hospital,Jilin University,Changchun 130033,China;Department of General Surgery,Nanhu Hospital,China-Japan Union Hospital,Jilin University,Changchun 130012,China)

机构地区：[1]吉林大学中日联谊医院超声科,吉林长春130033 [2]吉林大学中日联谊医院南湖院区普通外科,吉林长春130012

出　　处：《吉林大学学报（医学版）》2019年第1期170-174,220,共6页Journal of Jilin University：Medicine Edition

基　　金：吉林省财政厅吉林省直卫生专项项目资助课题(SCZSY201618);吉林省科技厅科技发展计划项目资助课题(20170414042G H)

摘　　要：目的:分析肝脏渡越时间与门静脉高压-食管胃底静脉曲张患者门静脉压力的关系,阐明其临床意义。方法:选择因门静脉高压-食管胃底静脉曲张行食管胃底曲张静脉栓塞术患者50例作为观察组,选择无肝病病史及肝病临床表现患者(住院或门诊)50例作为对照组。2组患者均行肝脏超声造影,观察组患者在超声引导下行门静脉穿刺时建立手术通路并测量自由门静脉压(FPP)。比较2组患者肝动脉-肝静脉渡越时间(HA-HVTT)、肝门静脉-肝静脉渡越时间(PV-HVTT)和肝实质-肝静脉渡越时间(PA-HVTT),分析观察组患者HA-HVTT、PV-HVTT、PA-HVTT与FPP的相关性。结果:与对照组比较,观察组患者HA-HVTT、PV-HVTT和PA-HVTT均明显缩短(t=5.078,P<0.01;t=12.163,P<0.01;t=2.649,P<0.01);观察组患者HA-HVTT、PV-HVTT、PA-HVTT与FPP均呈负相关关系(r=-0.799,P<0.01;r=-0.554,P<0.01;r=-0.735,P<0.01)。HA-HVTT与FPP线性关系为Y=-0.410X+7.254,PV-HVTT与FPP线性关系为Y=-0.355X+4.983,PA-HVTT与FPP线性关系为Y=-0.566X+4.997。结论:肝脏渡越时间可以成为判断门静脉压力的有效指标,为门静脉高压患者的诊断和治疗提供理论依据。Objective:To analyze the relationship of hepatic transit time and portal vein pressure in the patients with portal hypertension and esophagogastric varices,and to clarify its clinical significance.Methods:A total of 50 hospitalized patients underwent esophagogastric venous embolization due to portal hypertension and esophagogastric varices were selected as observation group,and 50 patients without history of liver disease and clinical manifestations of liver disease(hospitalized or out-patient)were selected as control group,All patients underwent liver contrast enhanced ultrasound.The free portal pressure(FPP)was measured by ultrasound guided portal vein puncture for operating pathways in the patients in observation group.The hepatic artery-hepatic vein transit time(HA-HVTT),the hepatic portal vein-hepatic vein transit time(PV-HVTT),the liver parenchyma-hepatic vein transit time(PA-HVTT)of the patients were compared between two groups.The correlations between HA-HVTT,PV-HVTT,PA-HVTT and FPP of the patients in observation group were analyzed.Results:The HA-HVTT,PV-HVTT and PA-HVTT of the patients in observation group were significantly shorter than those in control group(t=5.078,P<0.01;t=12.163,P<0.01;t=2.649,P<0.01).The HA-HVTT,PV-HVTT and PA-HVTT had negative correlations with FPP in observation group(r=-0.799,P<0.01;r=-0.554,P<0.01;r=-0.735,P<0.01).The linear relationship between HA-HVTT and FPP was Y=-0.410X+7.254;the linear relationship between PV-HVTT and FPP was Y=-0.355X+4.983;the linear relationship between PA-HVTT and FPP was Y=-0.566X+4.997.Conclusion:Liver transit time can be used as an effective index to judge the portal vein pressure,and it can provide the theroretical basis for the diagnosis and treatment of portal hypertension in the patients.

关 键 词：肝硬化 食管胃底静脉曲张 超声造影 渡越时间 门静脉压力 

分 类 号：R445.1[医药卫生—影像医学与核医学]