肝静脉彩色多普勒血流频谱在肝纤维化分期中的临床价值  

Clinical utility of color Doppler flow spectrum of hepatic vein for liver fibrosis staging

作　　者：陈勇良[1] 赵辉[2] 王晓静[1] 李秋雨 潘丽 李振燕[2] CHEN Yong-liang;ZHAO Hui;WANG Xiao-jing;LI Qiu-yu;PAN Li;LI Zhen-yan(Department of Infectious Disease,Shijiazhuang Fifth Hospital,Hebei 050021,China;Functional Section,Shijiazhuang Fifth Hospital,Hebei 050021,China)

机构地区：[1]石家庄市第五医院感染科,河北050021 [2]石家庄市第五医院功能科,河北050021

出　　处：《肝脏》2023年第8期907-911,共5页Chinese Hepatology

基　　金：石家庄市科学技术研究与发展计划(201201243);河北省医学科学研究课题计划(20221689)。

摘　　要：目的探讨肝左静脉、肝中静脉、肝右静脉彩色多普勒血流频谱在诊断肝纤维化分期中的应用价值。方法应用彩色多普勒超声检测344例慢性肝炎患者的肝左静脉、肝中静脉及肝右静脉频谱波形,全部病例均行肝组织穿刺活检病理诊断,将获得肝静脉频谱波形与肝纤维化分期进行对照分析。结果344例患者肝静脉频谱波形分为:双向波型(O型)、单向波型(Ⅰ型)、连续平坦型(Ⅱ型);按肝纤维化程度分为轻度(S0~S1)、中度(S2~S3)和重度(S4)三组。肝左静脉、肝中静脉、肝右静脉O、Ⅰ、Ⅱ波型与轻、中、重度三组间构成比差异有统计学意义(χ^(2)=30.090、29.447、15.572,P<0.001)。肝左静脉O型波、Ⅱ型波与肝纤维化分期比较差异有统计学意义(r=-0.268、0.194,P<0.001)。肝中静脉O型波、Ⅰ型波、Ⅱ型波与肝纤维化分期比较差异有统计学意义(r=-0.268、0.108、0.154,P<0.001、<0.05、<0.05)。肝右静脉O型波、Ⅱ型波与肝纤维化分期比较差异有统计学意义(r=-0.198、0.147,P<0.001、<0.05)。结论肝左静脉、肝中静脉、肝右静脉三支肝静脉彩色多普勒血流频谱均可较好地反映肝纤维化程度,其中肝中静脉频谱较肝左静脉及肝右静脉作为评估指标更可靠。Objective To investigate the value of color Doppler flow spectrum of left,middle and right hepatic veins in staging liver fibrosis.Methods In this study,Color Doppler ultrasound was used to record the spectral waveforms of the left,middle,and right hepatic veins in 344 patients with chronic hepatitis.All patients were subjected to a pathological liver biopsy for diagnosis,and the spectral waveforms obtained from the hepatic veins were subsequently compared with the liver fibrosis staging.Results The 344 patients with spectral waveforms of the hepatic vein were divided into three types:bi-direction wave(type O),uni-direction wave(type I),and continuous flat wave(type II).According to the degree of liver fibrosis,patients were also grouped into mild(S0~S1),moderate(S2~S3)and severe(S4)categories.The composition ratio of the left,middle and right hepatic veins exhibiting Type O,ⅠandⅡwaves,across the mild,moderate,and severe groups,showed significant differences withχ^(2)=30.090,29.447,15.572,P<0.001.The correlation between the liver fibrosis stage and type O and typeⅡwaves of the left hepatic vein was statistical significance(r=-0.268,0.194,P<0.001).The correlation between the liver fibrosis stage and type O,typeⅠand typeⅡwaves of the middle hepatic vein was also significant(r=-0.268,0.108,0.154,P<0.001,<0.05,<0.05).Moreover,the correlation between the liver fibrosis stage and,type O and typeⅡwaves of the right hepatic vein was significant(r=-0.198,0.147,P<0.001,<0.05).Conclusion The color Doppler blood flow spectrum from three hepatic veins-left,middle and right-proved a comprehensive reflection of the liver fibrosis degree.Moreover,the spectral readings from the middle hepatic vein appears to be more reliable than those from the left and right hepatic veins when used as an evaluation index.

关 键 词：肝脏血流动力学 肝静脉 彩色多普勒频谱 超声检查 肝纤维化分期 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575.2[医药卫生—诊断学]